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. 2022 Jan 12;22(1):36.
doi: 10.1186/s12887-022-03109-4.

Efficacy of rituximab therapy in children with nephrotic syndrome: a 10-year experience from an Iranian pediatric hospital

Behnaz Bazargani  1   2 , Zahra Noparast  1   3 , Leila Khedmat  4 , Daryoosh Fahimi  1   2 , Seyed Taher Esfahani  2 , Mastaneh Moghtaderi  1   2 , Arash Abbasi  1   2 , Azadeh Afshin  1   3 , Sayed Yousef Mojtahedi  5   6
Affiliations

Efficacy of rituximab therapy in children with nephrotic syndrome: a 10-year experience from an Iranian pediatric hospital

Behnaz Bazargani et al. BMC Pediatr. .

Abstract

Background: There are controversy results in the optimal management of children with steroid-dependent and steroid-resistant nephrotic syndrome (SDNS, SRNS). This study aimed to determine the efficacy and safety of rituximab (RTX) in these pediatric patients.

Methods: Medical records of 1-18-year-old Iranian children with SDNS (n = 26) and SRNS (n = 22) with a follow-up for at least 24 months were included from 2009 to 2019. The short- and long-term responses to RTX were respectively evaluated to determine the random protein-to-creatinine ratio after 6 and 24 months and classified as complete (CR) and partial (PR) remission or no response.

Results: Male patients (n = 26) were slightly predominate. The median age of patients at the time of RTX therapy was 8.6 ± 4.01 years. At the end of the 6-month follow-up, CR and PR occurred in 23 (47.9%) and 12 (25%) patients, respectively. Of 23 patients with CR, 18 (69.2%) and 5(22.7%) had SDNS and SRNS, respectively (p < 0.005). However, only 18 (37.5%) of patients after 24 months had been in CR. No significant difference in the CR rate was found between the two groups. RTX was more effective when administered during the proteinuria-free period (p = 0.001).

Conclusion: In the short term, RTX significantly was efficient in inducing complete or PR in SDNS and SRNS patients. However, the favorable response rate in a long-term follow-up was insignificantly lower between the two groups.

Keywords: Nephrotic syndrome; Pediatrics; Rituximab; Steroid dependent nephrotic syndrome; Steroid resistant nephrotic syndrome.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Fig. 1
Fig. 1
The relationship of NS type in both genders with (a) proteinuria before RTX treatment and (b) early outcome in pediatric patients
Fig. 2
Fig. 2
The mean comparison of disease duration based on early (a) and final (b) treatment outcomes of RTX in Iranian pediatric patients with NS
See this image and copyright information in PMC

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