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  11. Efficacy And Safety Of Scheduled Rituximab In Children With Refractory Nephrotic Syndrome After Multi-target Therapy Failure.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Paediatrics
  9. Infant And Child Health
  11. Efficacy And Safety Of Scheduled Rituximab In Children With Refractory Nephrotic Syndrome After Multi-target Therapy Failure.

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Efficacy and safety of scheduled rituximab in children with refractory nephrotic syndrome after multi-target therapy failure.

Jing Yang1, Yonghua He1, Jinyun Pu1

  • 1Department of Pediatrics, Hubei Provincial Key Laboratory of Pediatric Genetic Metabolic and Endocrine Rare Diseases, Hubei Provincial Clinical Research Center for Children's Growth and Development and Metabolic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Ave. No. 1095, Wuhan, 430030, China.

Pediatric Nephrology (Berlin, Germany)
|December 12, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

Scheduled rituximab (RTX) maintenance therapy significantly reduced relapses in children with refractory nephrotic syndrome (NS). This approach allowed for the discontinuation of steroids and other immunosuppressants, improving patient outcomes.

Keywords:
ChildrenMulti-target therapy failureRefractory nephrotic syndromeRituximab

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Area of Science:

  • Pediatric Nephrology
  • Immunosuppressive Therapy
  • Autoimmune Diseases

Background:

  • Refractory nephrotic syndrome (NS) in children often involves frequent relapses despite standard immunosuppressive treatments.
  • Multi-target therapy failure is common in children with difficult-to-treat NS.

Purpose of the Study:

  • To evaluate the efficacy and safety of scheduled rituximab (RTX) maintenance therapy.
  • To assess RTX's impact on relapse rates, medication reduction, and kidney outcomes in pediatric NS patients who failed prior therapies.

Main Methods:

  • Retrospective analysis of 48 children (<18 years) with steroid-dependent or resistant NS and multiple relapses.
  • Assessed relapse rates, medication reduction, adverse events, and renal outcomes before and after RTX maintenance therapy.
Scheduled therapy

Main Results:

  • RTX maintenance therapy drastically reduced the annual relapse rate from 2.1 to 0.2 (p < 0.0001).
  • 85% of patients discontinued corticosteroids, and 73% stopped other immunosuppressants, with 69% achieving remission on RTX alone.
  • Adverse events were generally mild, including hypogammaglobulinemia and transient neutropenia; no patients progressed to kidney failure.

Conclusions:

  • Scheduled RTX maintenance therapy is effective for maintaining remission in pediatric refractory NS.
  • RTX enables significant reduction or cessation of steroids and other immunosuppressants, improving long-term management.