QX Su, XJ Qi, YN Shen, ZY Dou, ZH Rong, X Zhao, B Yu, YX Wang, XL Wang

Abstract

Purpose: To analyse the efficacy and safety of rituximab (RTX) in the treatment of children with steroid-dependent or frequently relapsing nephrotic syndrome (NS). Methods: A total of 44 children were eligible for inclusion in this study, and they were randomly divided into the control group and the RTX group in a 1:1 ratio. The children in the control group received traditional treatment, that is, steroid and/or calcineurin inhibitors. As well as the traditional treatment, the RTX group was given RTX (375 mg/m2/time, maximum 500 mg/time, once a week) after the urine protein turned negative. Findings: After one year of follow-up, there were 17 cases (77.27%) in the RTX group who maintained continuous remission for six months, and 7 cases (31.81%) in the control group. The difference was statistically significant (p<0.1). The annual recurrence rate was 54.54% (12/22) in the RTX group and 95.45% (21/22) in the control group, and the difference was statistically significant (p<0.01). Compared with the control group, the recurrence-free survival time of the RTX group was significantly longer (p=0), the cumulative amount of steroid was reduced (p<0.05), and the period of being steroid-free was significantly longer (p=0). One case of pneumocystis pneumonia occurred in the RTX group, and there were no serious adverse events. There was no significant difference in the incidence of adverse events between the two groups. Conclusions: Rituximab is safe and effective in treating children with frequently relapsing or steroid-dependent NS.