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[Clinical study on low-dose rituximab maintenance therapy in children with primary nephrotic syndrome]

Wen-Ting Peng1, Xiao-Zhong Li

  • 1Department of Renal Immunology, Children's Hospital of Soochow University, Suzhou, Jiangsu 215000, China.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|August 20, 2025
PubMed

Insights

Low-dose rituximab (RTX) maintenance therapy effectively treats pediatric primary nephrotic syndrome (PNS), maintaining remission and reducing relapses. This safe treatment option also lowered steroid and tacrolimus use in children.

Area of Science:

  • Pediatric Nephrology
  • Clinical Immunology
  • Pharmacology

Context:

  • Primary nephrotic syndrome (PNS) is a significant cause of kidney disease in children.
  • Current treatments often involve long-term immunosuppression with potential side effects.
  • Rituximab (RTX) has emerged as a potential therapeutic option for refractory PNS.

Purpose:

  • To evaluate the clinical efficacy and safety of low-dose RTX maintenance therapy in pediatric patients with PNS.
  • To assess the impact of low-dose RTX on remission rates, relapse frequency, and the need for other immunosuppressants.

Summary:

  • A retrospective analysis of children with PNS treated with low-dose RTX (<375 mg/m²) was performed.
  • Results showed that low-dose RTX significantly maintained remission, reduced relapse frequency, and decreased the requirement for corticosteroids and tacrolimus (P<0.05).
  • Immunoglobulin G (IgG) levels remained stable, and no additional anti-infective prophylaxis was necessary.

Impact:

  • Low-dose RTX maintenance therapy offers an effective and safe treatment strategy for pediatric PNS.
  • This approach may reduce the cumulative burden of immunosuppression and associated toxicities in children with PNS.
  • Findings support the use of rituximab as a valuable tool in managing pediatric nephrotic syndrome.
Abstract

Keywords:
ChildLow dosePrimary nephrotic syndromeRituximab

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