Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome.
| Autor: | Niu XL; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China., Gu YF; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China., Feng D; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China., Hao S; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China., Kuang XY; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China., Wang P; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China., Huang WY; Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. |
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| Jazyk: | angličtina |
| Zdroj: | Renal failure [Ren Fail] 2024 Dec; Vol. 46 (2), pp. 2427173. Date of Electronic Publication: 2024 Nov 26. |
| DOI: | 10.1080/0886022X.2024.2427173 |
| Abstrakt: | Objective: To explore the long-term efficacy and safety of the first single dose of rituximab in children with steroid-dependent minimal-change nephrotic syndrome (SD-MCNS) over a two-year period after infusion. Methods: A 2-year retrospective observational study was performed on children with SD-MCNS who received the first single dose of rituximab (375 mg/m 2 ) from October 2011 to December 2018. Results: Seventy-seven patients (median age 8.17 years) were included. The efficacy of the first single-dose rituximab in children with SD-MCNS was 90.91% (70/77). An overall relapse rate of 78.33% was achieved. Older age at rituximab treatment onset (>8.46 years), a lower steroid-dependent dosage (<18.76 mg/m 2 ·d) and a higher CD4 + T-cell count before rituximab treatment (>31.22%) were positively related to treatment efficacy ( p < 0.05). Male sex, younger age at rituximab treatment onset, a higher IgE level before rituximab treatment, and a higher white blood cell count and CD3 + T-cell count at the time of steroid withdrawal were associated with disease relapse ( p < 0.05). A model for predicting relapse after rituximab treatment in SD-MCNS patients was established. Conclusions: The first single-dose rituximab treatment for children with SD-MCNS was effective and safe. Greater efficacy was observed in patients who were older at rituximab treatment onset, had a lower steroid-dependent dosage, or had a higher CD4 + T-cell count before rituximab treatment. In contrast, younger male patients with a higher IgE level experienced an increased occurrence of relapse. |
| Databáze: | MEDLINE |
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