Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome

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...

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Main Authors: Xiao-Ling Niu, Yun-Fan Gu, Dan Feng, Sheng Hao, Xin-Yu Kuang, Ping Wang, Wen-Yan Huang
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2024.2427173
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author Xiao-Ling Niu
Yun-Fan Gu
Dan Feng
Sheng Hao
Xin-Yu Kuang
Ping Wang
Wen-Yan Huang
author_facet Xiao-Ling Niu
Yun-Fan Gu
Dan Feng
Sheng Hao
Xin-Yu Kuang
Ping Wang
Wen-Yan Huang
author_sort Xiao-Ling Niu
collection DOAJ
description 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/m2) 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/m2·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.
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series Renal Failure
spelling doaj-art-d93d14e96a5343988ca2725e6b0f3f0f2025-08-20T03:12:50ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492024-12-0146210.1080/0886022X.2024.2427173Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic SyndromeXiao-Ling Niu0Yun-Fan Gu1Dan Feng2Sheng Hao3Xin-Yu Kuang4Ping Wang5Wen-Yan Huang6Department of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaDepartment of Nephrology, Rheumatology and Immunology, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, ChinaObjective 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/m2) 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/m2·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.https://www.tandfonline.com/doi/10.1080/0886022X.2024.2427173Rituximabsteroid-dependent minimal-change nephrotic syndromechildrenefficacyrelapse
spellingShingle Xiao-Ling Niu
Yun-Fan Gu
Dan Feng
Sheng Hao
Xin-Yu Kuang
Ping Wang
Wen-Yan Huang
Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome
Renal Failure
Rituximab
steroid-dependent minimal-change nephrotic syndrome
children
efficacy
relapse
title Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome
title_full Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome
title_fullStr Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome
title_full_unstemmed Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome
title_short Long Term Evaluations of First Single-dose Rituximab in Children with Steroid-Dependent Minimal-Change Nephrotic Syndrome
title_sort long term evaluations of first single dose rituximab in children with steroid dependent minimal change nephrotic syndrome
topic Rituximab
steroid-dependent minimal-change nephrotic syndrome
children
efficacy
relapse
url https://www.tandfonline.com/doi/10.1080/0886022X.2024.2427173
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