Document Detail


Rituximab is an efficient and safe treatment in adults with steroid-dependent minimal change disease.
MedLine Citation:
PMID:  23325085     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Development of steroid dependency in patients with nephrotic syndrome may require a long-term multi-drug therapy at risk of drug toxicity and renal failure. Rituximab treatment reduces the steroid dosage and the need for immunosuppressive therapy in pediatric patients. Here we retrospectively analyze the efficacy and safety of rituximab in adult patients with steroid-dependent minimal change disease. To do this, we analyzed the outcome of all adult patients treated with rituximab for steroid-dependent minimal change nephrotic syndrome over a mean follow-up of 29.5 months (range 5.1-82 months). Seventeen patients with steroid-dependent or frequently relapsing minimal change nephrotic syndrome, unresponsive to several immunosuppressive medications, were treated with rituximab. Eleven patients had no relapses after rituximab infusion (mean follow-up 26.7 months, range 5.1-82 months) and nine of them were able to come off all other immunosuppressive drugs and steroids during follow-up. Six patients relapsed at least once after a mean time of 11.9 months (mean follow-up 34.5 months, range 16.9-50.1 months), but their immunosuppressive drug treatment could be stopped or markedly reduced during this time. No adverse events were recorded. Thus, rituximab is efficient and safe in adult patients suffering from severe steroid-dependent minimal change disease. Prospective randomized trials are needed to confirm this study.
Authors:
Helene Munyentwali; Khedidja Bouachi; Vincent Audard; Philippe Remy; Philippe Lang; Rachid Mojaat; Georges Deschênes; Pierre M Ronco; Emmanuelle M Plaisier; Karine Y Dahan
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Publication Detail:
Type:  Journal Article     Date:  2013-01-16
Journal Detail:
Title:  Kidney international     Volume:  83     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-28     Completed Date:  2013-08-20     Revised Date:  2013-12-11    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  511-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antibodies, Monoclonal, Murine-Derived / adverse effects,  therapeutic use*
Antigens, CD19 / analysis
Antigens, CD20 / immunology*
Female
Humans
Immunosuppressive Agents / therapeutic use
Male
Middle Aged
Nephrosis, Lipoid / drug therapy*
Prednisone / therapeutic use*
Recurrence
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/Antigens, CD19; 0/Antigens, CD20; 0/Immunosuppressive Agents; 0/rituximab; VB0R961HZT/Prednisone
Comments/Corrections
Comment In:
Kidney Int. 2013 Nov;84(5):1050   [PMID:  24172741 ]
Kidney Int. 2013 Nov;84(5):1049   [PMID:  24172738 ]
Kidney Int. 2013 Mar;83(3):343-5   [PMID:  23446250 ]

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