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Multicenter analysis of the efficacy and safety of a non‐standard immunosuppressive therapy with rituximab in children with steroid‐resistant nephrotic syndrome

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Clinical and Experimental Pharmacology and Physiology

Published online on

Abstract

--- - |2 Abstract The aim of the study was a multicenter analysis of the efficacy and safety of a non‐standard immunosuppressive therapy with rituximab (Rtx) in children with steroid‐resistant nephrotic syndrome (SRNS) with particular emphasis on the possibility of permanent discontinuation or dose reduction of other immunosuppressive drugs such as glucocorticoids and cyclosporine A after 6 months of observation. The study group consisted of 30 children with idiopathic nephrotic syndrome, who were unresponsive to standard immunosuppressive treatment, and hospitalized in the years 2010‐2017 in 8 pediatric nephrology centers in Poland. [Tabl 1,2,3,4,9] The children were administered a single initial infusion of rituximab at the dose of 375 mg/m2 of the body surface area. Proteinuria, the daily supply of glucocorticoids, and cyclosporine were assessed at the moment of the start of the treatment and after 6 months since its commencement. Before Rtx therapy, complete remission was found in13 patients (43%) and partial remission was found in 8 patients (26%). These numbers increased to 16 (53%) and 12 (40%) respectively. At the start of the treatment 23 patients (76,6%) were treated with cyclosporine A. After 6 months, this number decreased to 15 patients (35%). At the start of the treatment, 18 patients (60%) were treated with prednisone. After 6 months, this number decreased to 8 patients (44%). Children with SRNS may potentially benefit from Rtx treatment despite relative risk of side effects. The benefits may include reduction of proteinuria or reduction of other immunosuppressants. This article is protected by copyright. All rights reserved. - 'Clinical and Experimental Pharmacology and Physiology, Volume 0, Issue ja, -Not available-. '