Rituximab for Steroid-Dependent Minimal Change Disease in Adults: Is It Time for a Change?

Minimal change disease (MCD) is a common cause of nephrotic syndrome, and steroid treatment is usually effective at the expense of adverse effects and frequent relapses. Rituximab, a monoclonal antibody against cluster of differentiation (CD)20 B-lymphocytes, leads to depletion of B-cells and has been frequently used to treat relapsing MCD in children. The efficacy of rituximab in treating adult MCD is limited. We report our experience with the use of rituximab for adult biopsy-proven MCD. Our series includes four adult patients (two males and two females), aged 22-80 years, treated with rituximab. All four patients achieved a complete remission with rituximab which lasted from 12 to 19 months. No adverse events from rituximab were observed. This shows the remarkable efficacy of rituximab in the treatment of minimal change disease in adults and may be preferred in patients at high risk for the development of adverse events from corticosteroids.