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Rituximab treatment for refractory nephrotic syndrome in adults: a multicenter retrospective study.
Ma, Xiaoyan; Fang, Lu; Sheng, Lili; Zhou, Xun; Bai, Shoujun; Zang, Xiujuan; Wang, Yakun; Li, Mengke; Lv, Zexin; Zhong, Qin; Yang, Xinyu; Wang, Yishu; Hu, Yan; Yan, Danying; Shi, Yingfeng; Chen, Hui; Li, Jinqing; Tao, Min; Zhuang, Shougang; Wang, Yi; Liu, Na.
Afiliação
  • Ma X; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Fang L; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Sheng L; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Zhou X; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Bai S; Department of Nephrology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, P.R. China.
  • Zang X; Department of Nephrology, Shanghai Songjiang District Central Hospital, Shanghai, P.R. China.
  • Wang Y; Department of Nephrology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, P.R. China.
  • Li M; Department of Nephrology, Shanghai Songjiang District Central Hospital, Shanghai, P.R. China.
  • Lv Z; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Zhong Q; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Yang X; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Wang Y; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Hu Y; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Yan D; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Shi Y; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Chen H; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Li J; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Tao M; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Zhuang S; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
  • Wang Y; Department of Medicine, Rhode Island Hospital and Alpert Medical School, Brown University, Providence, RI, USA.
  • Liu N; Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China.
Ren Fail ; 45(1): 2237124, 2023 Dec.
Article em En | MEDLINE | ID: mdl-37482915
BACKGROUND: The treatment of refractory nephrotic syndrome (RNS) is full of challenges and the role of rituximab (RTX) is not well-established, thus this study aims to demonstrate the role of RTX in RNS. METHODS: This was a multicenter retrospective study of all adult patients receiving RTX for RNS. Patients enrolled were divided into two groups according to pathological pattern: 20 patients as a group of podocytopathy (including minimal change disease [MCD] and focal and segmental glomerulosclerosis [FSGS]), and 26 patients as membranous nephropathy (MN) group. The remission rate, relapse rate, adverse effects, and predictors of remission were analyzed. RESULTS: A total of 75 patients received RTX for RNS and 48 were available for analysis after exclusion criteria. No significant difference in the remission rate at 6 or 12 months was observed between the MCD/FSGS and MN cases (p > 0.05). The median duration of the first complete remission (CR) was 1 month in the podocytopathy group and 12.5 months in the MN group. Three relapses were associated with infection as the ultimate outcome, and 6 out of 48 remained refractory representing a response rate of 87.5% in RNS. Clinical predictors of cumulative CR were estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and mean arterial pressure (MAP) ≤103 mmHg at the beginning of therapy in patients with MN. No serious adverse effects were reported. CONCLUSIONS: RTX appears to be effective in RNS across various clinical and pathological subtypes, exhibiting a low relapse rate and minimal significant side effects in the majority of patients.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Glomerulosclerose Segmentar e Focal / Glomerulonefrite Membranosa / Nefrose Lipoide / Síndrome Nefrótica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Glomerulosclerose Segmentar e Focal / Glomerulonefrite Membranosa / Nefrose Lipoide / Síndrome Nefrótica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article