Rituximab in children with resistant idiopathic nephrotic syndrome

Alberto Magnasco, Pietro Ravani, Alberto Edefonti, Luisa Murer, Luciana Ghio, Mirco Belingheri, Elisa Benetti, Corrado Murtas, Giovanni Messina, Laura Massella, Maria Gabriella Porcellini, Michela Montagna, Mario Regazzi, Francesco Scolari, Gian Marco Ghiggeri

Research output: Contribution to journalArticlepeer-review

Abstract

Idiopathic nephrotic syndrome resistant to standard treatments remains a therapeutic dilemma in pediatric nephrology. To test whether the anti-CD20 monoclonal antibody rituximab may benefit these patients, we conducted an open-label, randomized, controlled trial in 31 children with idiopathic nephrotic syndrome unresponsive to the combination of calcineurin inhibitors and prednisone. All children continued prednisone and calcineurin inhibitors at the doses prescribed before enrollment, and one treatment group received two doses of rituximab (375 mg/m 2 intravenously) as add-on therapy. Themean age was 8 years (range, 2-16 years). Rituximab did not reduce proteinuria at 3 months (change, 212% [95% confidence interval, 273% to 110%]; P=0.77 in analysis of covariance model adjusted for baseline proteinuria). Additional adjustment for previous remission and interaction terms (treatment by baseline proteinuria and treatment by previous remission) did not change the results. In conclusion, these data do not support the addition of rituximab to prednisone and calcineurin inhibitors in children with resistant idiopathic nephrotic syndrome.

Original languageEnglish
Pages (from-to)1117-1124
Number of pages8
JournalJournal of the American Society of Nephrology
Volume23
Issue number6
DOIs
Publication statusPublished - Jun 2012

ASJC Scopus subject areas

  • Nephrology

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