Wang Li, Zhu Jialiang, Xia Mingyun, Hua Ran, Deng Fang
Children's Hospital of Anhui Medical University, Anhui, China.
The First Affiliated Hospital of Anhui Medical University, Anhui, China.
Arch Med Sci. 2022 Jan 14;18(1):275-278. doi: 10.5114/aoms/145587. eCollection 2022.
Frequently-relapsing/steroid-dependent nephrotic syndrome (FRSDNS) leads to steroid toxicity impairing quality of life (QOL), thus prompting the use of steroid-sparing drugs.
51 FRSDNS children not previously treated with steroid-sparing agents were randomized to receive rituximab, cyclophosphamide, or tacrolimus. Clinical findings and QOL were evaluated before and after treatment.
The mean relapse rate in all groups declined six months after treatment, however, 1-year relapse-free survival rate, number of relapses, and cumulative prednisolone dosage were lower with rituximab than with tacrolimus and cyclophosphamide. Cyclophosphamide group had twice frequency of infections compared to the other groups. At 1 year after treatment, total scores showed greater improvement with rituximab.
As first-line steroid-sparing agent, rituximab is more effective and safer than cyclophosphamide and tacrolimus in FRSDNS, and improve QOL.
频繁复发/依赖类固醇的肾病综合征（FRSDNS）会导致类固醇毒性，损害生活质量（QOL），从而促使人们使用类固醇节约药物。
51名此前未接受过类固醇节约药物治疗的FRSDNS儿童被随机分为接受利妥昔单抗、环磷酰胺或他克莫司治疗。在治疗前后评估临床结果和生活质量。
治疗6个月后，所有组的平均复发率均下降，然而，利妥昔单抗治疗组的1年无复发生存率、复发次数和累积泼尼松龙剂量低于他克莫司和环磷酰胺治疗组。与其他组相比，环磷酰胺组的感染频率是其他组的两倍。治疗1年后，利妥昔单抗治疗组的总评分改善更大。
作为一线类固醇节约药物，利妥昔单抗在FRSDNS治疗中比环磷酰胺和他克莫司更有效、更安全，并且能改善生活质量。
