Universität zu Köln

Kronbichler, Andreas ORCID: 0000-0002-2945-2946, Kerschbaum, Julia, Fernandez-Fresnedo, Gema, Hoxha, Elion, Kurschat, Christine E., Busch, Martin, Bruchfeld, Annette ORCID: 0000-0002-9752-9941, Mayer, Gert ORCID: 0000-0002-5039-543X and Rudnicki, Michael (2014). Rituximab Treatment for Relapsing Minimal Change Disease and Focal Segmental Glomerulosclerosis: A Systematic Review. Am. J. Nephrol., 39 (4). S. 322 - 331. BASEL: KARGER. ISSN 1421-9670

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Abstract

Background: Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) remain a therapeutic challenge, since steroids and other immunosuppressive agents exhibit an unfavorable adverse event spectrum. The aim of this review was to systematically summarize and analyze data from preexisting studies reporting the outcome of rituximab (RTX) treatment in these patients. Methods: Study data on adult patients with either steroid-dependent or frequently relapsing MCD/FSGS were identified by a PubMed and Embase search. The number of relapses was calculated and the use of imnnunosuppressive co-medication prior to and after RTX treatment was quantified. Results: We identified 14 studies including 86 patients with frequently relapsing and steroid-dependent MCD or FSGS. Treatment with RTX reduced the number of relapses per year from 1.3 (0-9) relapses prior to treatment compared to 0 (0-2) after therapy (p < 0.001). Proteinuria decreased from 2.43 (0-15) g/day to 0 (0-4.89) g/day (p < 0.001), while serum albumin increased from 2.9 (1.2-4.6) at baseline to 4.0 (1.8-5.09) g/I after RTX (p = 0.001). The use of immunosuppression used at the time of RTX administration was also reduced after RTX therapy (p < 0.001). Baseline serum albumin was lower (p = 0.018), whereas the number of imnnunosuppressants prior to RTX was higher (p = 0.018) in patients with relapse after RTX. Condusions: The published data suggest that RTX is effective in reducing the number of relapses and sparing immunosuppression in frequently relapsing and steroid-dependent nephrotic syndrome due to MCD and FSGS. These promising findings have to be confirmed in controlled and prospective studies. (C) 2014 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kronbichler, Andreas UNSPECIFIED orcid.org/0000-0002-2945-2946 UNSPECIFIED Kerschbaum, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Fernandez-Fresnedo, Gema UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoxha, Elion UNSPECIFIED UNSPECIFIED UNSPECIFIED Kurschat, Christine E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Busch, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruchfeld, Annette UNSPECIFIED orcid.org/0000-0002-9752-9941 UNSPECIFIED Mayer, Gert UNSPECIFIED orcid.org/0000-0002-5039-543X UNSPECIFIED Rudnicki, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-451647
DOI:	10.1159/000360908
Journal or Publication Title:	Am. J. Nephrol.
Volume:	39
Number:	4
Page Range:	S. 322 - 331
Date:	2014
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1421-9670
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHANGE NEPHROTIC SYNDROME; SINGLE-DOSE RITUXIMAB; TERM-FOLLOW-UP; STEROID-RESISTANT; ADULT PATIENTS; B-CELLS; THERAPY; EFFICACY; CYCLOPHOSPHAMIDE; REMISSION Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/45164