Document Detail

Efficacy and safety of treatment with rituximab for difficult steroid-resistant and -dependent nephrotic syndrome: multicentric report.
MedLine Citation:
PMID:  20798255     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: The treatment of idiopathic nephrotic syndrome is often complicated by a refractory and relapsing course, with risk of drug toxicity and progressive renal failure. We report the efficacy and safety of rituximab in patients with steroid-resistant (SRNS) and steroid-dependent nephrotic syndrome (SDNS) refractory to standard therapy.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a cohort study in academic, tertiary care centers in India and the United States. Patients with SRNS or SDNS, not responding to medications or showing calcineurin inhibitor toxicity, treated with two to four doses of intravenous rituximab, and followed ≥12 months were included. Remission was termed as complete, partial, or no response.
RESULTS: Thirty-three patients with SRNS (24 initial, 9 late resistance) and 24 with SDNS, with mean ages of 12.7 ± 9.1 and 11.7 ± 2.9 years, respectively, were included. Six months after rituximab therapy, 9 (27.2%) patients with SRNS showed complete remission, 7 (21.2%) had partial remission, and 17 (51.5%) had no response. At 21.5 ± 11.5 months, remission was sustained in 15 (complete: 7, partial: 8) patients. Of 24 patients with SDNS, remission was sustained in 20 (83.3%) at 12 months and in 17 (71%) at follow-up of 16.8 ± 5.9 months. The mean difference in relapses before and 12 months after treatment with rituximab was 3.9 episodes/patient per year.
CONCLUSIONS: Therapy with rituximab was safe and effective in inducing and maintaining remission in a significant proportion of patients with difficult SRNS and SDNS.
Ashima Gulati; Aditi Sinha; Stanley C Jordan; Pankaj Hari; Amit K Dinda; Sonika Sharma; Rajendra N Srivastava; Asha Moudgil; Arvind Bagga
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-08-26
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  5     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-08     Completed Date:  2011-04-11     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2207-12     Citation Subset:  IM    
Division of Pediatric Nephrology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
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MeSH Terms
Adrenal Cortex Hormones / therapeutic use*
Antibodies, Monoclonal, Murine-Derived / adverse effects,  therapeutic use*
Antigens, CD19 / analysis
Child, Preschool
Cohort Studies
Drug Resistance
Follow-Up Studies
Nephrotic Syndrome / drug therapy*
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Antibodies, Monoclonal, Murine-Derived; 0/Antigens, CD19; 0/rituximab

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