Therapeutic efficacy of rituximab for the management of adult-onset steroid-dependent nephrotic syndrome: a retrospective study

Takayuki Katsuno, Tomohiro Masuda, Shoji Saito, Noritoshi Kato, Takuji Ishimoto, Sawako Kato, Tomoki Kosugi, Naotake Tsuboi, Hiroshi Kitamura, Toyonori Tsuzuki, Yasuhiko Ito, Shoichi Maruyama

研究成果: Article

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Background: Recent reports have described the efficacy of rituximab in treating steroid-dependent nephrotic syndrome (SDNS) in pediatric patients. However, few reports describe data regarding adult-onset SDNS. We investigated the efficacy of rituximab for the management of adult-onset SDNS. Methods: We performed a retrospective cohort study investigating eight patients with adult-onset SDNS who were treated with rituximab. Clinical data were obtained at the initiation of rituximab therapy. The primary outcomes evaluated were successful suppression of relapses and CD19+ cells after rituximab treatment. The corticosteroid- and immunosuppressant-sparing effect and adverse events were additionally evaluated. Results: All eight patients were diagnosed with minimal change nephrotic syndrome and received immunosuppressants in addition to corticosteroid. Total number of relapses was 10.5 times as a median value. Rituximab administration was repeated in two patients, whereas six received single-dose rituximab. Three of eight (37.5%) patients showed relapse after rituximab therapy. A rituximab-induced depletion in CD19+ cells noted initially was followed by their reappearance in all patients. There were cases with no relapse after the reappearance of CD19+ cells. The median relapse time pre- and post-rituximab therapy showed a decrease from 1 time/year (interquartile range [IQR] 1–3 times/year) to 0 time/year (IQR 0–1 time/year). Rituximab treatment induced a significant reduction in the required doses of corticosteroid and cyclosporine (P < 0.01). No serious adverse events were observed. Conclusion: Rituximab treatment was effective not only in childhood-onset but also in adult-onset SDNS. Further studies are needed to establish optimal treatment regimens.

元の言語English
ページ(範囲)207-214
ページ数8
ジャーナルClinical and Experimental Nephrology
23
発行部数2
DOI
出版物ステータスPublished - 15-02-2019

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

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    Katsuno, T., Masuda, T., Saito, S., Kato, N., Ishimoto, T., Kato, S., Kosugi, T., Tsuboi, N., Kitamura, H., Tsuzuki, T., Ito, Y., & Maruyama, S. (2019). Therapeutic efficacy of rituximab for the management of adult-onset steroid-dependent nephrotic syndrome: a retrospective study. Clinical and Experimental Nephrology, 23(2), 207-214. https://doi.org/10.1007/s10157-018-1630-y