No Benefit from Adjunct Rituximab in Children with Resistant Idiopathic Nephrotic Syndrome

In a randomized trial, adding rituximab to standard treatment did not reduce proteinuria.

Prednisone-resistant idiopathic nephrotic syndrome (INS) is one of the most frustrating chronic kidney diseases in children. Because of promising preliminary reports, the monoclonal anti-CD20 antibody rituximab has become a popular adjunctive therapy for resistant INS. In a multicenter, open-label, randomized trial, researchers examined the effectiveness of rituximab in 31 children (age range, 2–16 years) with INS that had been resistant to treatment with prednisone (with or without calcineurin inhibitors) for at least 6 months. Sixteen patients had initial drug resistance and 15 developed delayed resistance months to years after disease onset.

All patients continued to receive standard treatment with prednisone at study entry. Fifteen patie…

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)