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Both the rituximab dose and maintenance immunosuppression in steroid-dependent/ frequently-relapsing nephrotic syndrome have important effects on outcomes

Kidney International Nov 13, 2019

Chan EYH, Webb H, Yu E, et al. - Researchers undertook this international, multicenter retrospective analysis to define the optimal rituximab regimen to treat steroid-dependent/ frequently-relapsing nephrotic syndrome (SDFRNS) in children. This investigation was performed among children 1-18 years of age with complicated SDFRNS taking rituximab between 2005-2016 for 18 or more months follow-up, at 11 tertiary pediatric nephrology centers in Asia, Europe and North America. They evaluated the influence of rituximab prescribed at three dosing levels: low (375mg/m2), medium (750mg/m2) and high (1125-1500mg/m2), with or without maintenance immunosuppression. Overall 511 children (median age 11.5 year, 67% boys) were included, of those, low, medium and high dose rituximab was received by 191, 208 and 112, respectively. Maintenance immunosuppression was received by 283 (55%). Findings revealed the shortest relapse-free survival among children receiving low-dose rituximab without maintenance immunosuppression. Therefore, treatment outcomes are significantly influenced by both rituximab dose and maintenance immunosuppression.
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