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

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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.

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Authors and Affiliations

  1. Pediatric Nephrology, Hôpital des Enfants, Toulouse, France

    Stéphanie Tellier, Karine Brochard, Arnaud Garnier, Flavio Bandin & Stéphane Decramer

  2. Pediatric Nephrology, Hôpital Pellegrin, Bordeaux, France

    Brigitte Llanas

  3. Department of Pediatrics, Hôpital de la mère et de l’enfant, Limoges, France

    Vincent Guigonis

  4. Pediatric Nephrology, Hôpital de la Timone Enfants, Marseille, France

    Mathilde Cailliez

  5. Department of Pediatrics, CHU Reims, Reims, France

    Christine Pietrement

  6. Department of Pediatrics, Hôpital de Saint-Denis, La Réunion, France

    Olivier Dunand

  7. Department of Pediatrics, Hôpital André Mignot, Versailles, France

    Sylvie Nathanson

  8. Pediatric Nephrology, Hôpital Femme-Mère-Enfants, Lyon, France

    Aurélia Bertholet-Thomas

  9. Pediatric Nephrology, Hôpital Arnaud de Villeneuve, Montpellier, France

    Lydia Ichay

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  1. Stéphanie Tellier
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  2. Karine Brochard
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Correspondence to Stéphanie Tellier.

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Tellier, S., Brochard, K., Garnier, A. et al. Long-term outcome of children treated with rituximab for idiopathic nephrotic syndrome. Pediatr Nephrol 28, 911–918 (2013). https://doi.org/10.1007/s00467-012-2406-3

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  • DOI: https://doi.org/10.1007/s00467-012-2406-3

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