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Rituximab in steroid-sensitive nephrotic syndrome: lessons from clinical trials

Kazumoto Iijima1, Mayumi Sako2, Koichi Kamei3

  • 1Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. iijima@med.kobe-u.ac.jp.

Pediatric Nephrology (Berlin, Germany)
|July 19, 2017
PubMed

Insights

Rituximab effectively treats childhood nephrotic syndrome, including frequently relapsing and steroid-dependent forms. This review examines recent studies on rituximab

Area of Science:

  • Pediatric Nephrology
  • Immunology
  • Pharmacology

Background:

  • Idiopathic nephrotic syndrome is a common pediatric glomerular disease.
  • Most children achieve remission with steroids (steroid-sensitive nephrotic syndrome, SSNS).
  • However, 50% develop frequent relapses (FRNS) or steroid dependence (SDNS), with 10-20% remaining refractory to immunosuppressants (complicated FRNS/SDNS).

Purpose of the Study:

  • To review recent randomized controlled trials of rituximab for childhood SSNS.
  • To evaluate rituximab's efficacy in complicated and uncomplicated FRNS/SDNS.
  • To discuss the impact of rituximab on managing pediatric nephrotic syndrome.

Main Methods:

  • Review of recent randomized controlled trials (RCTs).
  • Focus on studies investigating rituximab in children with SSNS, FRNS, and SDNS.
  • Analysis of treatment outcomes and management strategies.

Main Results:

  • Rituximab is increasingly used for SSNS in children.
  • Studies highlight rituximab's role in managing FRNS and SDNS, including complicated cases.
  • Evidence suggests rituximab can induce and maintain remission in refractory cases.

Conclusions:

  • Rituximab shows promise as a treatment option for difficult-to-treat childhood nephrotic syndrome.
  • Recent studies support its use in FRNS and SDNS, offering an alternative to conventional immunosuppressants.
  • Further research continues to define rituximab's optimal role in pediatric nephrotic syndrome management.

Keywords:
Clinical managementClinical trialFrequently relapsing nephrotic syndromeRandomizedRituximabSteroid-dependent nephrotic syndrome

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