Rituximab for troublesome cases of childhood nephrotic syndrome
Rituximab for troublesome cases of childhood nephrotic syndrome作者机构：Department of Pediatrics King Abdulaziz University Hospital Pediatric Nephrology UnitKing Abdulaziz University Hospital
出 版 物：《World Journal of Clinical Pediatrics》 (世界临床儿科杂志)
年 卷 期：2014年第3卷第4期
页 面：69-75页
学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学]
主 题：Rituximab Pediatric Nephrotic syndrome Efficacy Safety
摘 要：Nephrotic syndrome(NS) is the most common glomerular disease of childhood. Steroid-dependent and steroid-resistant nephrotic syndrome present challenges in their pharmaceutical management; patients may need several immunosuppressive medication for optimum control, each of which medication has its own safety profile. Rituximab(RTX) is a monoclonal antibody that targets B cells and has been used successfully for management of lymphoma and rheumatoid arthritis. Recent clinical studies showed that rituximab may be an efficacious and safe alternative for the treatment of complicated nephrotic syndrome. In this review article, we aim to review the efficacy and safety of RTX therapy in nephrotic syndrome. We reviewed the literature pertaining to this topic by searching for relevant studies on Pub Med and Medline using specific keywords. The initial search yielded 452 articles. These articles were then examined to ensure their relevance to the topic of research. We focused on multicenter randomized controlled trials with relatively large numbers of patients. A total of 29 articles were finally identified and will be summarized in this review. The majority of clinical studies of RTX in complicated pediatric NS showed that rituximab is effective in approximately 80% of patients with steroid-dependent NS, as it decreases the number of relapses and steroid dosage. However, RTX is less effective at achieving remission in steroid-resistant NS. RTX use was generally safe, and most side effects were transient and infusion-related. More randomized, double-blinded clinical studies are needed to assess the role of RTX in children with nephrotic syndrome.
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