Rituximab in young adults with steroids dependence nephrotic syndrome: a case series

We aim to assess the efficacy of rituximab (RTX) in treating adults with steroid-dependent nephrotic syndromes (SDNS) or frequently relapsing nephrotic syndromes (FRNS), whose disease was diagnosed during childhood.We analyzed the clinical course of patients with nephrotic syndromes (NS) onset in childhood who received RTX treatment for SDNS or FRNS after childhood (> 16 years).All patients had minimal change disease (MCD) or focal and segmental glomeruloesclerosis ( FSG) proven by biopsy.We analysed patient characteristics and outcomes.Twelve patients (n = 8 MCD, n = 4 FSG).The median exposure time to steroids prior to RTX was 19 years (range: 2-31.5 years).NS was diagnosed at a median age of 3 years (range: 1.5-6.0years), the median age when patients received their first RTX dose was 24 years (range: 16-42 years).After RTX treatment, all patients achieved remission not needing any immunosuppressive drugs.The relapse rate decreased by 8 times (rate ratio: 8.7; 95% CI: 2.1-40.5)and the average prednisone dose was reduced (19.6 17.5 mg vs. 4.6 8.6 mg/ dL; p = 0.0027).RTX was effective in reducing the number of relapses and steroid loading in young adults with SDNS or FRNS with an adequate safety profile.