Department of Nephrology, Rheumatology and Immunology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Ren Fail. 2024 Dec;46(2):2427173. doi: 10.1080/0886022X.2024.2427173. Epub 2024 Nov 26.
To explore the long-term efficacy and safety of the first single dose of rituximab in children with steroid-dependent minimal-change nephrotic syndrome (SD-MCNS) over a two-year period after infusion.
A 2-year retrospective observational study was performed on children with SD-MCNS who received the first single dose of rituximab (375 mg/m) from October 2011 to December 2018.
Seventy-seven patients (median age 8.17 years) were included. The efficacy of the first single-dose rituximab in children with SD-MCNS was 90.91% (70/77). An overall relapse rate of 78.33% was achieved. Older age at rituximab treatment onset (>8.46 years), a lower steroid-dependent dosage (<18.76 mg/m·d) and a higher CD4 T-cell count before rituximab treatment (>31.22%) were positively related to treatment efficacy (0.05). Male sex, younger age at rituximab treatment onset, a higher IgE level before rituximab treatment, and a higher white blood cell count and CD3 T-cell count at the time of steroid withdrawal were associated with disease relapse (0.05). A model for predicting relapse after rituximab treatment in SD-MCNS patients was established.
The first single-dose rituximab treatment for children with SD-MCNS was effective and safe. Greater efficacy was observed in patients who were older at rituximab treatment onset, had a lower steroid-dependent dosage, or had a higher CD4 T-cell count before rituximab treatment. In contrast, younger male patients with a higher IgE level experienced an increased occurrence of relapse.
探讨首剂利妥昔单抗治疗儿童激素依赖性微小病变肾病综合征（SD-MCNS）患者在输注后 2 年内的长期疗效和安全性。
对 2011 年 10 月至 2018 年 12 月接受首剂利妥昔单抗（375mg/m）治疗的 SD-MCNS 患儿进行了一项为期 2 年的回顾性观察研究。
共纳入 77 例患儿（中位年龄 8.17 岁）。首剂利妥昔单抗治疗 SD-MCNS 患儿的疗效为 90.91%（70/77）。总复发率为 78.33%。利妥昔单抗治疗起始年龄较大（＞8.46 岁）、激素依赖性剂量较低（＜18.76mg/m·d）和利妥昔单抗治疗前 CD4 T 细胞计数较高（＞31.22%）与治疗疗效呈正相关（0.05）。男性、利妥昔单抗治疗起始年龄较小、利妥昔单抗治疗前 IgE 水平较高、激素撤药时白细胞计数和 CD3 T 细胞计数较高与疾病复发相关（0.05）。建立了预测 SD-MCNS 患者利妥昔单抗治疗后复发的模型。
首剂利妥昔单抗治疗儿童 SD-MCNS 有效且安全。利妥昔单抗治疗起始年龄较大、激素依赖性剂量较低或利妥昔单抗治疗前 CD4 T 细胞计数较高的患者疗效较好。相反，IgE 水平较高的年轻男性患儿复发发生率较高。
