The outcome of rituximab in treating steroid dependent nephrotic syndrome
Objectives: To present our experience of treating steroid-dependent nephrotic syndrome (SDNS) in children with repeated doses of rituximab (RTX) with a relatively long follow-up, and to discuss the role of the histopathology type and previous immune-suppressor (IS) drugs on the outcome of these pati...
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| Veröffentlicht in: | Saudi medical journal 2022-07, Vol.43 (7), p.760-764 |
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| creator | Al Salloum Abdullah A Al Herbish Adi J Al Hissi Mohammed A Abdalla, Mohammed S Salim, Suha B Farhat, Afrah H Shagal, Reem A Othman Abduldafaee Alshaiban Abdulelah Temsah Mohamad-Hani A Al-Eyadhy, Ayman A Alhasan, Khalid A |
| description | Objectives: To present our experience of treating steroid-dependent nephrotic syndrome (SDNS) in children with repeated doses of rituximab (RTX) with a relatively long follow-up, and to discuss the role of the histopathology type and previous immune-suppressor (IS) drugs on the outcome of these patients. Methods: The patients included in this prospective study were children with SDNS who were in remission on a high-dose steroid or with additional IS drugs. All patients underwent renal biopsy before RTX treatment. Intravenous RTX was administered monthly at 375 mg/m2 for 4 doses. Response to treatment was defined as maintaining remission with no steroid-sparing agents or prednisone for one year. Results: Seventeen (14 males) patients were enrolled. Approximately 76% had minimal change disease (MCD) and 3 (18%) patients had immunoglobulin M (IgM) nephropathy. Approximately 85% of MCD and 33% of IgM nephropathy showed complete response to RTX. Conclusion: Compared to other IS used to treat SDNS, RTX showed a significant decrease in relapse rate with fewer side effects. The dose and interval should be modified according to the patient’s characteristics, such as medical history, pathology type, and previous IS agents. |
| doi_str_mv | 10.15537/smj.2022.43.7.20210727 |
| format | Article |
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Methods: The patients included in this prospective study were children with SDNS who were in remission on a high-dose steroid or with additional IS drugs. All patients underwent renal biopsy before RTX treatment. Intravenous RTX was administered monthly at 375 mg/m2 for 4 doses. Response to treatment was defined as maintaining remission with no steroid-sparing agents or prednisone for one year. Results: Seventeen (14 males) patients were enrolled. Approximately 76% had minimal change disease (MCD) and 3 (18%) patients had immunoglobulin M (IgM) nephropathy. Approximately 85% of MCD and 33% of IgM nephropathy showed complete response to RTX. Conclusion: Compared to other IS used to treat SDNS, RTX showed a significant decrease in relapse rate with fewer side effects. The dose and interval should be modified according to the patient’s characteristics, such as medical history, pathology type, and previous IS agents.</description><identifier>ISSN: 0379-5284</identifier><identifier>EISSN: 1658-3175</identifier><identifier>DOI: 10.15537/smj.2022.43.7.20210727</identifier><language>eng</language><publisher>Riyadh: Prince Sultan Military Medical City (PSMMC)</publisher><subject>Clinical outcomes ; Histopathology ; Immunotherapy ; Kidney diseases ; Monoclonal antibodies ; Pediatrics ; Steroids</subject><ispartof>Saudi medical journal, 2022-07, Vol.43 (7), p.760-764</ispartof><rights>Saudi Medical Journal 2022. This work is licensed under the Creative Commons Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1317-f91eb2d8bbf74ea54875f69091e014b5b463610e6b164decad05759036e1a4803</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Al Salloum Abdullah A</creatorcontrib><creatorcontrib>Al Herbish Adi J</creatorcontrib><creatorcontrib>Al Hissi Mohammed A</creatorcontrib><creatorcontrib>Abdalla, Mohammed S</creatorcontrib><creatorcontrib>Salim, Suha B</creatorcontrib><creatorcontrib>Farhat, Afrah H</creatorcontrib><creatorcontrib>Shagal, Reem A</creatorcontrib><creatorcontrib>Othman Abduldafaee</creatorcontrib><creatorcontrib>Alshaiban Abdulelah</creatorcontrib><creatorcontrib>Temsah Mohamad-Hani A</creatorcontrib><creatorcontrib>Al-Eyadhy, Ayman A</creatorcontrib><creatorcontrib>Alhasan, Khalid A</creatorcontrib><title>The outcome of rituximab in treating steroid dependent nephrotic syndrome</title><title>Saudi medical journal</title><description>Objectives: To present our experience of treating steroid-dependent nephrotic syndrome (SDNS) in children with repeated doses of rituximab (RTX) with a relatively long follow-up, and to discuss the role of the histopathology type and previous immune-suppressor (IS) drugs on the outcome of these patients. Methods: The patients included in this prospective study were children with SDNS who were in remission on a high-dose steroid or with additional IS drugs. All patients underwent renal biopsy before RTX treatment. Intravenous RTX was administered monthly at 375 mg/m2 for 4 doses. Response to treatment was defined as maintaining remission with no steroid-sparing agents or prednisone for one year. Results: Seventeen (14 males) patients were enrolled. Approximately 76% had minimal change disease (MCD) and 3 (18%) patients had immunoglobulin M (IgM) nephropathy. Approximately 85% of MCD and 33% of IgM nephropathy showed complete response to RTX. Conclusion: Compared to other IS used to treat SDNS, RTX showed a significant decrease in relapse rate with fewer side effects. The dose and interval should be modified according to the patient’s characteristics, such as medical history, pathology type, and previous IS agents.</description><subject>Clinical outcomes</subject><subject>Histopathology</subject><subject>Immunotherapy</subject><subject>Kidney diseases</subject><subject>Monoclonal antibodies</subject><subject>Pediatrics</subject><subject>Steroids</subject><issn>0379-5284</issn><issn>1658-3175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNotjktLxDAUhYMoWEd_gwHXrffm2S5l8DEw4GZcD01z63Rw0pqkoP_eiq6-w4HzYOwWoUKtpb1Pp2MlQIhKycr-KgQr7Bkr0Oi6lGj1OStA2qbUolaX7CqlI4A0BkzBNrsD8XHO3Xha2PM45PlrOLWOD4HnSG0ewjtPmeI4eO5pouApZB5oOsQxDx1P38HHJX3NLvr2I9HNP1fs7elxt34pt6_Pm_XDtuxw-VL2DZITvnaut4parWqre9PAYgMqp50y0iCQcWiUp671oK1ulr-ErapBrtjdX-8Ux8-ZUt4fxzmGZXIvTIM1Sg2N_AGCzFB5</recordid><startdate>20220701</startdate><enddate>20220701</enddate><creator>Al Salloum Abdullah A</creator><creator>Al Herbish Adi J</creator><creator>Al Hissi Mohammed A</creator><creator>Abdalla, Mohammed S</creator><creator>Salim, Suha B</creator><creator>Farhat, Afrah H</creator><creator>Shagal, Reem A</creator><creator>Othman Abduldafaee</creator><creator>Alshaiban Abdulelah</creator><creator>Temsah Mohamad-Hani A</creator><creator>Al-Eyadhy, Ayman A</creator><creator>Alhasan, Khalid A</creator><general>Prince Sultan Military Medical City (PSMMC)</general><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20220701</creationdate><title>The outcome of rituximab in treating steroid dependent nephrotic syndrome</title><author>Al Salloum Abdullah A ; Al Herbish Adi J ; Al Hissi Mohammed A ; Abdalla, Mohammed S ; Salim, Suha B ; Farhat, Afrah H ; Shagal, Reem A ; Othman Abduldafaee ; Alshaiban Abdulelah ; Temsah Mohamad-Hani A ; Al-Eyadhy, Ayman A ; Alhasan, Khalid A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1317-f91eb2d8bbf74ea54875f69091e014b5b463610e6b164decad05759036e1a4803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Clinical outcomes</topic><topic>Histopathology</topic><topic>Immunotherapy</topic><topic>Kidney diseases</topic><topic>Monoclonal antibodies</topic><topic>Pediatrics</topic><topic>Steroids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al Salloum Abdullah A</creatorcontrib><creatorcontrib>Al Herbish Adi J</creatorcontrib><creatorcontrib>Al Hissi Mohammed A</creatorcontrib><creatorcontrib>Abdalla, Mohammed S</creatorcontrib><creatorcontrib>Salim, Suha B</creatorcontrib><creatorcontrib>Farhat, Afrah H</creatorcontrib><creatorcontrib>Shagal, Reem A</creatorcontrib><creatorcontrib>Othman Abduldafaee</creatorcontrib><creatorcontrib>Alshaiban Abdulelah</creatorcontrib><creatorcontrib>Temsah Mohamad-Hani A</creatorcontrib><creatorcontrib>Al-Eyadhy, Ayman A</creatorcontrib><creatorcontrib>Alhasan, Khalid A</creatorcontrib><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Saudi medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Al Salloum Abdullah A</au><au>Al Herbish Adi J</au><au>Al Hissi Mohammed A</au><au>Abdalla, Mohammed S</au><au>Salim, Suha B</au><au>Farhat, Afrah H</au><au>Shagal, Reem A</au><au>Othman Abduldafaee</au><au>Alshaiban Abdulelah</au><au>Temsah Mohamad-Hani A</au><au>Al-Eyadhy, Ayman A</au><au>Alhasan, Khalid A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The outcome of rituximab in treating steroid dependent nephrotic syndrome</atitle><jtitle>Saudi medical journal</jtitle><date>2022-07-01</date><risdate>2022</risdate><volume>43</volume><issue>7</issue><spage>760</spage><epage>764</epage><pages>760-764</pages><issn>0379-5284</issn><eissn>1658-3175</eissn><abstract>Objectives: To present our experience of treating steroid-dependent nephrotic syndrome (SDNS) in children with repeated doses of rituximab (RTX) with a relatively long follow-up, and to discuss the role of the histopathology type and previous immune-suppressor (IS) drugs on the outcome of these patients. Methods: The patients included in this prospective study were children with SDNS who were in remission on a high-dose steroid or with additional IS drugs. All patients underwent renal biopsy before RTX treatment. Intravenous RTX was administered monthly at 375 mg/m2 for 4 doses. Response to treatment was defined as maintaining remission with no steroid-sparing agents or prednisone for one year. Results: Seventeen (14 males) patients were enrolled. Approximately 76% had minimal change disease (MCD) and 3 (18%) patients had immunoglobulin M (IgM) nephropathy. Approximately 85% of MCD and 33% of IgM nephropathy showed complete response to RTX. Conclusion: Compared to other IS used to treat SDNS, RTX showed a significant decrease in relapse rate with fewer side effects. 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| subjects | Clinical outcomes Histopathology Immunotherapy Kidney diseases Monoclonal antibodies Pediatrics Steroids |
| title | The outcome of rituximab in treating steroid dependent nephrotic syndrome |
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