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Pediatric Nephrology

, Volume 28, Issue 6, pp 911–918 | Cite as

Long-term outcome of children treated with rituximab for idiopathic nephrotic syndrome

  • Stéphanie Tellier
  • Karine Brochard
  • Arnaud Garnier
  • Flavio Bandin
  • Brigitte Llanas
  • Vincent Guigonis
  • Mathilde Cailliez
  • Christine Pietrement
  • Olivier Dunand
  • Sylvie Nathanson
  • Aurélia Bertholet-Thomas
  • Lydia Ichay
  • Stéphane Decramer
Original Article

Abstract

Background

Rituximab (RTX) has recently showed promising results in the treatment of steroid-dependent idiopathic nephrotic syndrome (SDNS).

Methods

This was a retrospective multicenter study of 18 children treated with RTX for SDNS, with a mean follow-up of 3.2 years. RTX was introduced because of side effects or relapses during therapy with immunosuppressive agents. The children received one to four infusions of RTX during the first course of treatment, and subsequent infusions were given due to CD19-cell recovery (CD19 >1 %; 54 % of children) or relapse (41 %), as well as systematically (5 %).

Results

Treatment with RTX maintained sustained remission without relapse in 22 % of patients and increased the duration of remission in all other patients. The time between two successive relapses was 9 months in the absence of re-treatment and 24.5 months when infusions were performed at the time of CD19-cell recovery. At the last follow-up, 44.5 % of patients were free of oral drug therapy. Of those still receiving oral drugs, all doses had been decreased. No serious adverse events occurred.

Conclusion

The results of this retrospective study confirm the efficacy and very good safety of RTX in the treatment of SDNS. The optimal therapeutic protocol seems to be a repeated single infusion at the time of CD19-cell recovery.

Keywords

Anti-CD20 monoclonal antibody Steroid dependent idiopathic nephrotic syndrome Efficacy Side effects Follow-up Children 

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Copyright information

© IPNA 2013

Authors and Affiliations

  • Stéphanie Tellier
    • 1
  • Karine Brochard
    • 1
  • Arnaud Garnier
    • 1
  • Flavio Bandin
    • 1
  • Brigitte Llanas
    • 2
  • Vincent Guigonis
    • 3
  • Mathilde Cailliez
    • 4
  • Christine Pietrement
    • 5
  • Olivier Dunand
    • 6
  • Sylvie Nathanson
    • 7
  • Aurélia Bertholet-Thomas
    • 8
  • Lydia Ichay
    • 9
  • Stéphane Decramer
    • 1
  1. 1.Pediatric NephrologyHôpital des EnfantsToulouseFrance
  2. 2.Pediatric NephrologyHôpital PellegrinBordeauxFrance
  3. 3.Department of PediatricsHôpital de la mère et de l’enfantLimogesFrance
  4. 4.Pediatric NephrologyHôpital de la Timone EnfantsMarseilleFrance
  5. 5.Department of PediatricsCHU ReimsReimsFrance
  6. 6.Department of PediatricsHôpital de Saint-DenisLa RéunionFrance
  7. 7.Department of PediatricsHôpital André MignotVersaillesFrance
  8. 8.Pediatric NephrologyHôpital Femme-Mère-EnfantsLyonFrance
  9. 9.Pediatric NephrologyHôpital Arnaud de VilleneuveMontpellierFrance

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