Rituximab is a safe and effective long-term treatment for children with steroid and calcineurin inhibitor–dependent idiopathic nephrotic syndrome

Pietro Ravani; Alessandro Ponticelli; Chiara Siciliano; Alessia Fornoni; Alberto Magnasco; Felice Sica; Monica Bodria; Gianluca Caridi; Changli Wei; Mirco Belingheri; Luciana Ghio; Sandra Merscher-Gomez; Alberto Edefonti; Andrea Pasini; Giovanni Montini; Corrado Murtas; Xiangyu Wang; Daniel Muruve; Augusto Vaglio; Davide Martorana; Antonello Pani; Francesco Scolari; Jochen Reiser; Gian M Ghiggeri

doi:10.1038/ki.2013.211

Back

Rituximab is a safe and effective long-term treatment for children with steroid and calcineurin inhibitor–dependent idiopathic nephrotic syndrome

Journal article

Open access

Peer reviewed

Rituximab is a safe and effective long-term treatment for children with steroid and calcineurin inhibitor–dependent idiopathic nephrotic syndrome

Pietro Ravani, Alessandro Ponticelli, Chiara Siciliano, Alessia Fornoni, Alberto Magnasco, Felice Sica, Monica Bodria, Gianluca Caridi, Changli Wei, Mirco Belingheri, …

Kidney international, Vol.84(5), pp.1025-1033

2013-11

DOI: https://doi.org/10.1038/ki.2013.211

PMID: 23739238

Abstract

clinical trial

proteinuria

nephrotic syndrome

pediatrics

In children with idiopathic nephrotic syndrome, rituximab can maintain short-term remission with withdrawal of prednisone and calcineurin inhibitors. Long-term effects including the number of repeated infusions to maintain remission are unknown. To test this, we treated 46 consecutive children with idiopathic nephrotic syndrome lasting for at least 1 year (mean 6.3 years), maintained in remission with oral prednisone and calcineurin inhibitors. They received 1–5 rituximab courses during a median follow-up of 3 years. Oral agents were tapered after each infusion, and completely withdrawn within 45 days. Rituximab was well tolerated. Six-month probabilities of remission were 48% after the first infusion and 37% after subsequent infusions. One- and 2-year-remission probabilities were, respectively, 20 and 10%. Median time intervals between complete oral-agent withdrawal and relapse were 5.6 and 8.5 months, respectively, following the first and subsequent courses. The time to reconstitution of CD20 cells correlated with the duration of remission, but was not associated with variation in FcyR, CD20, or SMPDL-3B polymorphisms. Podocyte Src phosphorylation was normal. Thus, rituximab can be safely and repeatedly used as a prednisone and calcineurin inhibitor–sparing therapy in a considerable proportion of children with dependent forms of idiopathic nephrotic syndrome. Further study is needed to identify patients who will benefit most from rituximab therapy.

Files and links (1)

url

https://doi.org/10.1038/ki.2013.211View

Published (Version of record) Open

Metrics

7 Record Views

83 Times Cited - Web of Science

See more details

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types: Domestic collaboration; International collaboration
Citation topics: 1 Clinical & Life Sciences; 1.55 Urology & Nephrology - General; 1.55.820 IgA Nephropathy
Web Of Science research areas: Urology & Nephrology
ESI research areas: Clinical Medicine

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

Source: InCites

Details

Title: Rituximab is a safe and effective long-term treatment for children with steroid and calcineurin inhibitor–dependent idiopathic nephrotic syndrome
Creators: Pietro Ravani - Division of Nephrology, Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
Alessandro Ponticelli - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Chiara Siciliano - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Alessia Fornoni - Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Illinois, USA
Alberto Magnasco - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Felice Sica - Division of Pediatrics, Hospital of Foggia, Foggia, Italy
Monica Bodria - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Gianluca Caridi - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Changli Wei - Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Illinois, USA
Mirco Belingheri - Pediatric Nephrology and Dialysis Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Policlinico, Milan, Italy
Luciana Ghio - Pediatric Nephrology and Dialysis Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Policlinico, Milan, Italy
Sandra Merscher-Gomez - Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Illinois, USA
Alberto Edefonti - Pediatric Nephrology and Dialysis Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Policlinico, Milan, Italy
Andrea Pasini - Nephrology and Pediatric Dialysis, Department of Pediatrics, Azienda Ospedaliera, Universitaria Sant'Orsola, Bologna, Italy
Giovanni Montini - Nephrology and Pediatric Dialysis, Department of Pediatrics, Azienda Ospedaliera, Universitaria Sant'Orsola, Bologna, Italy
Corrado Murtas - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Xiangyu Wang - Division of Nephrology, Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
Daniel Muruve - Division of Nephrology, Department of Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
Augusto Vaglio - Dipartimento di Clinica Medica e Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
Davide Martorana - Dipartimento di Clinica Medica e Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
Antonello Pani - Nefrologia e Dialisi, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
Francesco Scolari - Division of Nephrology and Dialysis, Ospedale di Montichiari, Brescia, Italy
Jochen Reiser - Department of Medicine, Rush University, Chicago, Illinois, USA
Gian M Ghiggeri - Division of Nephrology, Dialysis, Transplantation, and Laboratory on Pathophysiology of Uremia, Istituto G. Gaslini, Genoa, Italy
Publication Details: Kidney international, Vol.84(5), pp.1025-1033
Publisher: Elsevier Inc
Academic Unit: Miller School of Medicine; Peggy and Harold Katz Family Drug Discovery Center
Language: English
Resource Type: Journal article
PMID: 23739238
Record Identifier: 991031578740502976