Rituximab treatment of adults with primary focal segmental glomerulosclerosis

• Published in: Scientific reports Vol. 13; no. 1; p. 6740
• Main Authors: Wang, Liuwei, Yu, Lu, Wang, Yulin, Guo, Yanhong, Zhai, Zihan, Tang, Lin
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 25.04.2023; Nature Publishing Group UK; Nature Portfolio
• Subjects: Adult; End-stage renal disease; Glomerulosclerosis, Focal Segmental - complications; Glucocorticoids; Glucocorticoids - therapeutic use; Humans; Immunosuppressive agents; Kidney diseases; Lymphocytes B; Male; Nephrotic syndrome; Nephrotic Syndrome - complications; Nephrotic Syndrome - drug therapy; Patients; Peripheral blood; Recurrence; Remission; Remission (Medicine); Retrospective Studies; Rituximab; Rituximab - adverse effects; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-023-33678-y

To evaluate the efficacy and safety of rituximab (RTX) in the treatment of primary focal segmental glomerulosclerosis (FSGS) in adults. The clinical data of patients with primary FSGS who received RTX treatment in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively. The selected patients received RTX twice or four times, with a single dose of 375 mg/m , and the interval between two times of administration of RTX was 2-4 weeks. The treatment target is to achieve the clearance of B cells (peripheral blood B cell count < 5/μl). The primary outcome measures were remission and recurrence of renal disease, and the secondary outcome measures were adverse events and renal outcomes. A total of 14 FSGS patients were included, including 12 males, 9 with glucocorticoid-dependent or frequently relapsing nephrotic syndrome, and 3 with newly diagnosed nephrotic syndrome. After RTX treatment, 7 patients with glucocorticoid-dependent/recurrent nephrotic syndrome were completely relieved. At 6 months of follow-up, glucocorticoids were discontinued in all patients except 1 patient. The other 5 patients achieved partial remission (PR), of which 1 patient relapsed after PR, and 1 initial patient achieved complete remission. One patient progressed to end-stage renal disease (ESRD) after 4 months of follow-up. RTX in the treatment of adult glucocorticoid-dependent/relapsing FSGS can reduce the risk of recurrence and help to decline or discontinue the use of glucocorticoid and immunosuppressants.