Extended infusion of rituximab combined with steroids is effective in inducing remission and reducing relapse in adult minimal change disease
BACKGROUND: Minimal change disease is a common cause of nephrotic syndrome in adults. Higher relapse rate put patients at risk of steroids toxicity due to long-term exposure. Rituximab has been suggested to maintain long time remission and withdraw steroids and other immunosuppressants with fewer adverse events. However, optimal dose and dosing interval have not been explored.
METHODS: Twenty-five patients were enrolled from 2017-10 to 2020-03 in Nanfang Hospital in China. Clinical and biological data were extracted from medical records and laboratory databases. Therapy composed of 375mg/m2 rituximab once three weeks for 3 dose and corticosteroid was applied. Complete remission was defined as reduction of proteinuria to 0.3g/d. Remission rate, relapse rate, steroids used before and after rituximab therapy and adverse effects were documented at a mean time of 14.71 months.
RESULTS: Twenty-two patients achieved complete remission for an average of 3.26 months and only 3 patients experienced one relapse respectively during the follow-up period. The mean remission maintenance time was 11.6 months, and was 5 months after steroids withdrawal. Steroids dose at last follow-up was 6.09mg/d, which was significantly reduced compared to 28.15mg/d before rituximab. Relapse rate before and after rituximab was 1.43 and 0.1, respectively. Only four minor adverse events were recorded.
CONCLUSIONS: Therapy consisted of 375mg/m2 rituximab once three weeks for 3 dose combined with corticosteroid is effective in inducing remission in adult patients with minimal change disease. Both of the relapse rate and dose of steroids used are significantly decreased with fewer side effects.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
|---|---|
| Enthalten in: |
BMC nephrology - 22(2021), 1 vom: 01. Juli, Seite 242 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Liu, Diankun [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
4F4X42SYQ6 |
|---|
| Anmerkungen: |
Date Completed 07.02.2022 Date Revised 07.02.2022 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1186/s12882-021-02437-4 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM327570008 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM327570008 | ||
| 003 | DE-627 | ||
| 005 | 20231225201055.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s12882-021-02437-4 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1091.xml |
| 035 | |a (DE-627)NLM327570008 | ||
| 035 | |a (NLM)34210283 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Liu, Diankun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Extended infusion of rituximab combined with steroids is effective in inducing remission and reducing relapse in adult minimal change disease |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.02.2022 | ||
| 500 | |a Date Revised 07.02.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Minimal change disease is a common cause of nephrotic syndrome in adults. Higher relapse rate put patients at risk of steroids toxicity due to long-term exposure. Rituximab has been suggested to maintain long time remission and withdraw steroids and other immunosuppressants with fewer adverse events. However, optimal dose and dosing interval have not been explored | ||
| 520 | |a METHODS: Twenty-five patients were enrolled from 2017-10 to 2020-03 in Nanfang Hospital in China. Clinical and biological data were extracted from medical records and laboratory databases. Therapy composed of 375mg/m2 rituximab once three weeks for 3 dose and corticosteroid was applied. Complete remission was defined as reduction of proteinuria to 0.3g/d. Remission rate, relapse rate, steroids used before and after rituximab therapy and adverse effects were documented at a mean time of 14.71 months | ||
| 520 | |a RESULTS: Twenty-two patients achieved complete remission for an average of 3.26 months and only 3 patients experienced one relapse respectively during the follow-up period. The mean remission maintenance time was 11.6 months, and was 5 months after steroids withdrawal. Steroids dose at last follow-up was 6.09mg/d, which was significantly reduced compared to 28.15mg/d before rituximab. Relapse rate before and after rituximab was 1.43 and 0.1, respectively. Only four minor adverse events were recorded | ||
| 520 | |a CONCLUSIONS: Therapy consisted of 375mg/m2 rituximab once three weeks for 3 dose combined with corticosteroid is effective in inducing remission in adult patients with minimal change disease. Both of the relapse rate and dose of steroids used are significantly decreased with fewer side effects | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Adult | |
| 650 | 4 | |a Minimal change disease | |
| 650 | 4 | |a Rituximab | |
| 650 | 4 | |a Steroids | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Serum Albumin |2 NLM | |
| 650 | 7 | |a Rituximab |2 NLM | |
| 650 | 7 | |a 4F4X42SYQ6 |2 NLM | |
| 650 | 7 | |a Creatinine |2 NLM | |
| 650 | 7 | |a AYI8EX34EU |2 NLM | |
| 700 | 1 | |a Zhou, Zhanmei |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Mengyi |e verfasserin |4 aut | |
| 700 | 1 | |a Nie, Sheng |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Bianxiang |e verfasserin |4 aut | |
| 700 | 1 | |a He, Wenjuan |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Guobao |e verfasserin |4 aut | |
| 700 | 1 | |a Ai, Jun |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t BMC nephrology |d 2000 |g 22(2021), 1 vom: 01. Juli, Seite 242 |w (DE-627)NLM109571673 |x 1471-2369 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2021 |g number:1 |g day:01 |g month:07 |g pages:242 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s12882-021-02437-4 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2021 |e 1 |b 01 |c 07 |h 242 | ||