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Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown
P. Gauckler, JI. Shin, F. Alberici, V. Audard, A. Bruchfeld, M. Busch, CK. Cheung, M. Crnogorac, E. Delbarba, K. Eller, S. Faguer, K. Galesic, S. Griffin, Z. Hrušková, A. Jeyabalan, A. Karras, C. King, HS. Kohli, R. Maas, G. Mayer, S. Moiseev, M....
Language English Country Netherlands
Document type Journal Article, Review
- MeSH
- Adult MeSH
- Glomerulosclerosis, Focal Segmental * drug therapy MeSH
- Immunologic Factors therapeutic use MeSH
- Immunosuppressive Agents adverse effects MeSH
- Humans MeSH
- Nephrosis, Lipoid * drug therapy MeSH
- Nephrotic Syndrome MeSH
- Recurrence MeSH
- Rituximab therapeutic use MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Primary forms of minimal change disease and focal segmental glomerulosclerosis are rare podocytopathies and clinically characterized by nephrotic syndrome. Glucocorticoids are the cornerstone of the initial immunosuppressive treatment in these two entities. Especially among adults with minimal change disease or focal segmental glomerulosclerosis, relapses, steroid dependence or resistance are common and necessitate re-initiation of steroids and other immunosuppressants. Effective steroid-sparing therapies and introduction of less toxic immunosuppressive agents are urgently needed to reduce undesirable side effects, in particular for patients whose disease course is complex. Rituximab, a B cell depleting monoclonal antibody, is increasingly used off-label in these circumstances, despite a low level of evidence for adult patients. Hence, critical questions concerning drug-safety, long-term efficacy and the optimal regimen for rituximab-treatment remain unanswered. Evidence in the form of large, multicenter studies and randomized controlled trials are urgently needed to overcome these limitations.
Department of Cardiovascular Sciences University of Leicester Leicester United Kingdom
Department of Health Medicine and Caring Sciences Linköping University Linköping Sweden
Department of Internal Medicine 4 Section of Nephrology Klinikum Wels Grieskirchen Wels Austria
Department of Nephrology and Transplantation University Hospital of Wales Cardiff UK
Department of Nephrology Juntendo University Faculty of Medicine Tokyo Japan
Department of Nephrology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen Netherlands
Department of Nephrology University of Brescia Hospital of Montichiari Brescia Italy
Department of Pediatrics Yonsei University College of Medicine Seoul 03722 Republic of Korea
Division of Nephrology and Hypertension Mayo Clinic Rochester MN USA
Division of Nephrology Columbia University Medical Center NY New York USA
Division of Pediatric Nephrology Severance Children's Hospital Seoul 03722 Republic of Korea
Institut National de la Santé et de la Recherche Médicale U1048 31000 Toulouse France
John Walls Renal Unit University Hospitals of Leicester NHS Trust Leicester United Kingdom
Medical Faculty Johannes Kepler University Linz Altenberger Strasse 69 4040 Linz Austria
Nephrology Post Graduate Institute of Medical Education and Research Chandigarh India
Nephrology Unit ASST Spedali Civili di Brescia Brescia Italy
Tareev Clinic of Internal Diseases Sechenov 1st Moscow State Medical University Moscow Russia
University College London Department of Renal Medicine Royal Free Hospital London UK
References provided by Crossref.org
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