Repeated administration of rituximab for refractory nephroticsyndrome in children

Abstract

 Although most children with idiopathic nephrotic syndrome (INS) respond initially to steroid therapy, considerable number of patients demonstrate frequent relapses, steroid―dependency and steroid―resistance and show significant steroid toxicity.
 Recently, several non―controlled clinical trials have suggested that rituximab, a chimeric monoclonal antibody inhibiting CD20―mediated B―cell proliferation and differentiation, is effective for children with refractory INS, though an established regimen does not exist.
 We are in process of clinical trial to evaluate the efficacy and safety of repeated administration of rituximab (375 mg/m² body surface area, four times every three months) for patients with refractory nephrotic syndrome. In this article, literature review of the rituximab treatment for refractory nephrotic syndrome in children and our first successful case treated with repeated administration of rituximab will be introduced.