| Nephrotic syndrome and rituximab: facts and perspectives. | |
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MedLine Citation:
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PMID: 19495800 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Idiopathic nephrotic syndrome is the most frequent glomerular disease that presents during childhood and is mainly due to minimal change nephropathy (MCNS) and focal-segmental glomerulosclerosis (FSGS). Its treatment is still challenging, with up to 50% of the patients who are initially steroid sensitive (usually MCNS) being frequent relapsers and requiring additional long-term immunosuppression. However, current immunosuppressive regimens are associated with severe toxicity. Only half of the steroid-resistant patients (usually FSGS) achieve long-term remission even with intensive immunosuppression and plasma exchange. Rituximab (RTX), a chimeric monoclonal antibody inhibiting CD20-mediated B-cell proliferation and differentiation, has recently gained attention as a potentially successful therapy for complicated idiopathic nephrotic syndrome in children. A number of case reports and one prospective non-controlled multicenter trial point to the beneficial effects of RTX as a rescue therapy in children with steroid/cyclosporine-dependent or -resistant nephrotic syndrome. However, publication bias often results in positive outcomes being more likely to be reported than negative ones and, in particular, the safety profile of this drug in this group of patients remains unclear. Therefore, controlled randomized studies are required to assess this issue, to develop treatment guidelines, to evaluate the therapeutic and economical efficacy, and to define criteria for the selection of patients. |
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Authors:
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Dieter Haffner; Dagmar-Christiane Fischer |
Publication Detail:
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Type: Editorial; Review Date: 2009-06-04 |
Journal Detail:
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Title: Pediatric nephrology (Berlin, Germany) Volume: 24 ISSN: 1432-198X ISO Abbreviation: Pediatr. Nephrol. Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-06-17 Completed Date: 2009-08-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8708728 Medline TA: Pediatr Nephrol Country: Germany |
Other Details:
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Languages: eng Pagination: 1433-8 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies, Monoclonal
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therapeutic use* Child Cyclosporine / therapeutic use Humans Immunologic Factors / therapeutic use* Nephrotic Syndrome / drug therapy* Steroids / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunologic Factors; 0/Steroids; 0/rituximab; 59865-13-3/Cyclosporine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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