Rituximab for minimal change disease in adults: long-term follow-up.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
MetadataShow full item record
CitationNephrol. Dial. Transplant. 2014, 29 (4):851-6
AbstractMinimal change nephropathy or disease (MCD) accounts for 10-15% of cases of the nephrotic syndrome in adults with frequent relapses occurring in up to 25% of cases. The drug of choice is glucocorticoids (GCs), but GC-dependence is seen in 25-30%. Treatment with rituximab has been found to be effective in relapsing and GC-dependent cases, but little data are available regarding long-term outcome in adults.
We present nine female and seven male patients, ranging from 19 to 73 years of age with multirelapsing, GC-dependent or GC-resistant disease with a kidney biopsy consistent with MCD. Twelve patients were steroid-dependent with a lowest daily GC dose between 5 and 20 mg/day.
Rituximab with a total dose 1000-2800 mg divided in two to four doses was given together with GC achieving B-cell depletion before the second dose. No major side-effects occurred. Thirteen of the patients responded with complete remission enabling discontinuation or tapering of GC significantly below levels, where relapses had occurred in the past (P < 0.001). Two patients reached partial remission and one had no response to therapy. Follow-up was 12-70 months (median 44). Eight patients have remained in remission, whereas relapses occurred in seven patients after 9-28 months with repeated rituximab treatment in four of these.
Our study reinforces the role of rituximab as a GC-sparing agent in the challenging GC-dependent and multirelapsing MCD patients. In this emerging therapeutic field randomized studies with extended follow-up will add important information regarding optimal treatment, relapse and safety.
DescriptionTo access publisher's full text version of this article click on the hyperlink at the bottom of the page
RightsArchived with thanks to Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
- Rituximab for minimal-change nephrotic syndrome in adulthood: predictive factors for response, long-term outcomes and tolerance.
- Authors: Guitard J, Hebral AL, Fakhouri F, Joly D, Daugas E, Rivalan J, Guigonis V, Ducret F, Presne C, Pirson Y, Hourmant M, Glachant JC, Vendrely B, Moranne O, Faguer S, Chauveau D
- Issue date: 2014 Nov
- Long-term prognosis of adult patients with steroid-dependent minimal change nephrotic syndrome following rituximab treatment.
- Authors: Iwabuchi Y, Takei T, Moriyama T, Itabashi M, Nitta K
- Issue date: 2014 Dec
- Effect of single-dose rituximab on steroid-dependent minimal-change nephrotic syndrome in adults.
- Authors: Takei T, Itabashi M, Moriyama T, Kojima C, Shiohira S, Shimizu A, Tsuruta Y, Ochi A, Amemiya N, Mochizuki T, Uchida K, Tsuchiya K, Nitta K
- Issue date: 2013 May
- The Evolving Role of Rituximab in Adult Minimal Change Glomerulopathy.
- Authors: Brown LC, Jobson MA, Payan Schober F, Chang EH, Falk RJ, Nachman PH, Pendergraft WF
- Issue date: 2017
- Our experience with rituximab therapy for adult-onset primary glomerulonephritis and review of literature.
- Authors: Kong WY, Swaminathan R, Irish A
- Issue date: 2013 Jun