Efficacy and Safety of Rituximab Therapy to Sustain Remission in Young Children With Childhood Nephrotic Syndrome
Introduction: The efficacy and safety of rituximab in children aged < 6 years with frequently-relapsing and/or steroid-dependent nephrotic syndrome (FRSDNS) remain controversial. Methods: We conducted a retrospective cohort study at 16 pediatric nephrology centers from 10 countries in Asia, Europe, and North America. We first analyzed young children with FRSDNS who received their first rituximab treatment before the age of 6 years. As a secondary analysis, we matched young children aged < 6 years with older patients who received their first rituximab between the ages of 6 to 21 years. Results: = 0.01; neutropenia, 13% vs. 7%; infection, 9% vs. 4%). Conclusion: Rituximab offers reasonable efficacy in young children with FRSDNS, with a trend toward a shorter relapse-free period and more potential complications. Rituximab should be reserved until established treatments are exhausted.
Authors
- Guillaume Dorval (ORCID: https://orcid.org/0000-0003-3883-1398)
- Chantida Subun (ORCID: https://orcid.org/0000-0003-3027-315X)
- Kjell Tullus (ORCID: https://orcid.org/0000-0002-6234-6221)
- Gian Marco Ghiggeri (ORCID: https://orcid.org/0000-0003-3659-9062)
- Hazel Webb
- Zainab Arslan (ORCID: https://orcid.org/0000-0002-1126-3995)
- Chang‐Yien Chan (ORCID: https://orcid.org/0000-0001-5841-1417)
- Manuela Colucci (ORCID: https://orcid.org/0000-0003-0969-7521)
- Rulan S. Parekh (ORCID: https://orcid.org/0000-0001-6313-5752)
- Eugene Yu-hin Chan (ORCID: https://orcid.org/0000-0002-1463-6005)
- Kenji Ishikura (ORCID: https://orcid.org/0000-0003-2692-6437)
- Julien Hogan
- Chun Ting Au
- Seetha Radhakrishnan (ORCID: https://orcid.org/0000-0003-1102-7623)
- Sharon Teo
- Hui Kim Yap
- Olivia Boyer
- Rajiv Sinha
- Koichi Kamei
- Qian Shen
- Claire Dossier
- Cal Robinson
- Alison Lap-tak Ma
- Markus J. Kemper
- Tomohiko Yamamura
- Hong Xu
- Marina Vivarelli
- Andrea Angeletti
- Ellen L.M. Yu
- Riku Hamada
Institutions
- National University of Singapore (SG)
- Chinese University of Hong Kong (HK)
- Université Paris Cité (FR)
- Great Ormond Street Hospital (GB)
- Hospital for Sick Children (CA)
- Istituto Giannina Gaslini (IT)
- Women's College Hospital (CA)
- Institut Necker Enfants Malades (FR)
- Phramongkutklao Hospital (TH)
- MSH Medical School Hamburg – University of Applied Sciences and Medical University (DE)
- Duchess of Kent Children's Hospital (CN)
- Assistance Publique – Hôpitaux de Paris (FR)
- Princess Margaret Hospital (NZ)
- Bambino Gesù Children's Hospital (IT)
- Hôpital Robert-Debré (FR)
- Princess Margaret Hospital (HK)
- National Center For Child Health and Development (JP)
- Institute of Child Health (IN)
- Tokyo Metropolitan Children's Medical Center (JP)
- National University Health System (SG)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Children's Hospital of Fudan University (CN)
- Asklepios (DE)
- University College London (GB)
- Kitasato University (JP)
- Kobe University (JP)
Publication Details
- Journal
- Kidney International Reports
- Published
- 2026-04-06
- DOI
- https://doi.org/10.1016/j.ekir.2026.106526
- Primary Topic
- Renal Diseases and Glomerulopathies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Physicians' Services Incorporated Foundation
- Women's College Hospital
- Canadian Institutes of Health Research