TY - JOUR
T1 - Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown?
AU - for the RITERM study group
AU - Gauckler, Philipp
AU - Shin, Jae Il
AU - Alberici, Federico
AU - Audard, Vincent
AU - Bruchfeld, Annette
AU - Busch, Martin
AU - Cheung, Chee Kay
AU - Crnogorac, Matija
AU - Delbarba, Elisa
AU - Eller, Kathrin
AU - Faguer, Stanislas
AU - Galesic, Kresimir
AU - Griffin, Siân
AU - Hrušková, Zdenka
AU - Jeyabalan, Anushya
AU - Karras, Alexandre
AU - King, Catherine
AU - Kohli, Harbir Singh
AU - Maas, Rutger
AU - Mayer, Gert
AU - Moiseev, Sergey
AU - Muto, Masahiro
AU - Odler, Balazs
AU - Pepper, Ruth J.
AU - Quintana, Luis F.
AU - Radhakrishnan, Jai
AU - Ramachandran, Raja
AU - Salama, Alan D.
AU - Segelmark, Mårten
AU - Tesař, Vladimír
AU - Wetzels, Jack
AU - Willcocks, Lisa
AU - Windpessl, Martin
AU - Zand, Ladan
AU - Zonozi, Reza
AU - Kronbichler, Andreas
N1 - Funding Information:
VA reports grants from ADDMEDICA , outside the submitted work; AB reports consulting fees from Chemocentryx, from Merck/MSD and from Astra Zeneca, outside the submitted work; MB reports lecture fees from Boehringer Ingelheim , from Bristol-Myers Squibb , from Novartis, travel support from Hexal, lecture fees and travel support from Vifor Fresenius and lecture fee from Servier, outside the submitted work; CKC reports grants from GlaxoSmithKline, grants and consultancy fees from Retrophin, outside the submitted work; SF reports lecture fees from VIFOR Pharma , outside the submitted work; CK reports being funded by National Institute for Health Research (NIHR) as academic clinical fellow (ACF), during the conduct of the study. All the other authors declared no competing interests.
Publisher Copyright:
© 2020 The Author(s)
PY - 2020/11
Y1 - 2020/11
N2 - Primary forms of minimal change disease and focal segmental glomerulosclerosis are rare podocytopathies and clinically characterized by nephrotic syndrome. Glucocorticoids are the cornerstone of the initial immunosuppressive treatment in these two entities. Especially among adults with minimal change disease or focal segmental glomerulosclerosis, relapses, steroid dependence or resistance are common and necessitate re-initiation of steroids and other immunosuppressants. Effective steroid-sparing therapies and introduction of less toxic immunosuppressive agents are urgently needed to reduce undesirable side effects, in particular for patients whose disease course is complex. Rituximab, a B cell depleting monoclonal antibody, is increasingly used off-label in these circumstances, despite a low level of evidence for adult patients. Hence, critical questions concerning drug-safety, long-term efficacy and the optimal regimen for rituximab-treatment remain unanswered. Evidence in the form of large, multicenter studies and randomized controlled trials are urgently needed to overcome these limitations.
AB - Primary forms of minimal change disease and focal segmental glomerulosclerosis are rare podocytopathies and clinically characterized by nephrotic syndrome. Glucocorticoids are the cornerstone of the initial immunosuppressive treatment in these two entities. Especially among adults with minimal change disease or focal segmental glomerulosclerosis, relapses, steroid dependence or resistance are common and necessitate re-initiation of steroids and other immunosuppressants. Effective steroid-sparing therapies and introduction of less toxic immunosuppressive agents are urgently needed to reduce undesirable side effects, in particular for patients whose disease course is complex. Rituximab, a B cell depleting monoclonal antibody, is increasingly used off-label in these circumstances, despite a low level of evidence for adult patients. Hence, critical questions concerning drug-safety, long-term efficacy and the optimal regimen for rituximab-treatment remain unanswered. Evidence in the form of large, multicenter studies and randomized controlled trials are urgently needed to overcome these limitations.
KW - Focal segmental glomerulosclerosis
KW - Infections
KW - Long-term remission
KW - Minimal change disease
KW - Nephrotic syndrome
KW - Rituximab
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U2 - 10.1016/j.autrev.2020.102671
DO - 10.1016/j.autrev.2020.102671
M3 - Review article
C2 - 32942039
AN - SCOPUS:85091214005
VL - 19
JO - Autoimmunity Reviews
JF - Autoimmunity Reviews
SN - 1568-9972
IS - 11
M1 - 102671
ER -