Rituximab in steroid resistant nephrotic syndrome

  • Agomoni Chaki Resident ,Phase B,Department of Pediatric Nephrology,Bangabondhu Sheikh Mujib Medical University
  • Farhana Rahman Resident ,Phase B,Department of Pediatric Nephrology,Bangabondhu Sheikh Mujib Medical University
  • Jahanara Arju Resident ,Phase B,Department of Pediatric Nephrology,Bangabondhu Sheikh Mujib Medical University
  • Abdullah- Al Mamun Assistant professor,Bangabondhu Sheikh Mujib Medical University
  • Tahmina Jesmin Associate professor,Bangabondhu Sheikh Mujib Medical University
  • Sayed Saimul Huque Associate professor,Bangabondhu Sheikh Mujib Medical University
  • Afroza Begum Associate professor,Bangabondhu Sheikh Mujib Medical University
  • Habibur Rahman Professor, Dept of Pediatric Nephrology,Bangabondhu Sheikh Mujib Medical University
  • Goam Muin Uddin Professor, Dept of Pediatric Nephrology,Bangabondhu Sheikh Mujib Medical University
  • Ranjit Ranjan Roy Professor & chairman, Dept of Pediatric Nephrology,Bangabondhu Sheikh Mujib Medical University
DOI: https://doi.org/10.14238/pi59.4.2019.175-82
Keywords: nephrotic syndrome; Rituximab; steroid resistant

Abstract

Background Nephrotic syndrome (NS) is one of the most common glomerular disease in children, characterized by massive proteinuria, hypoalbuminemia, dyslipidemia and edema. Steroid-resistant nephrotic syndrome (SRNS) and steroid-dependent nephrotic syndrome (SDNS) present challenges in pharmaceutical management. Patient need several immunosuppressant for optimal control, each of which has significant side effect and difficult to get  desired results. Rituximab (RTX) is a monoclonal antibody that targets B cells and has been shown to be effective for patients with SRNS and SDNS.

Objective To see efficacy of RTX in pediatric patients with SRNS.

Method This retrospective study took place in Pediatric Nephrology Department of Bangabandhu Sheikh Mujib Medical University from July 2017 to June 2019. Patients diagnosed with SRNS who were treated with RTX and followed up for 6 months were enrolled in this study. Primary endpoint was achievement of remission after rituximab infusion; secondary endpoint was relapse-free survival rate in 6 months period following rituximab infusion.

Results Total  7 patients were recruited in this study. Among them 4 were male. Clinical and lab parameters of all patients before and after RTX  were compared. Complete remission achieved in 4/7 patients, partial remission in 2/7 patients and no response in 1/7 patient. Mean number of relapse in 3 patients before RTX infusion was 3.67 (SD 0.57) and after 0.33 (SD 0.00) (P=0.038).

Conclusion RTX is a biological agent that is effective and promising drug in children with SRNS. Rituximab is useful to induce and maintain remission.

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Published
2019-07-16
How to Cite
1.
Chaki A, Rahman F, Arju J, Al Mamun A-, Jesmin T, Huque S, Begum A, Rahman H, Uddin G, Roy R. Rituximab in steroid resistant nephrotic syndrome. PI [Internet]. 16Jul.2019 [cited 22Nov.2024];59(4):175-2. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2168
Issue
Vol 59 No 4 (2019): July 2019
Section
Pediatric Nephrology

Copyright (c) 2019 Agomoni Chaki, Farhana Rahman, Jahanara Arju, Abdullah- Al Mamun, Tahmina Jesmin, Sayed Saimul Huque, Afroza Begum, Habibur Rahman, Goam Muin Uddin, Ranjit Ranjan Roy

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Received 2019-03-24
Accepted 2019-07-16
Published 2019-07-16