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Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown?

Gauckler, Philipp ; Shin, Jae Il ; Alberici, Federico ; Audard, Vincent ; Bruchfeld, Annette ; Busch, Martin ; Cheung, Chee Kay ; Crnogorac, Matija ; Delbarba, Elisa and Eller, Kathrin , et al. (2020) In Autoimmunity Reviews 19(11).
Abstract

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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Focal segmental glomerulosclerosis, Infections, Long-term remission, Minimal change disease, Nephrotic syndrome, Rituximab
in
Autoimmunity Reviews
volume
19
issue
11
article number
102671
publisher
Elsevier
external identifiers
  • scopus:85091214005
  • pmid:32942039
ISSN
1568-9972
DOI
10.1016/j.autrev.2020.102671
language
English
LU publication?
yes
id
13943642-b975-448e-b9e8-224e792f9dea
date added to LUP
2020-10-27 13:13:11
date last changed
2021-01-06 03:10:54
@article{13943642-b975-448e-b9e8-224e792f9dea,
  abstract     = {<p>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.</p>},
  author       = {Gauckler, Philipp and Shin, Jae Il and Alberici, Federico and Audard, Vincent and Bruchfeld, Annette and Busch, Martin and Cheung, Chee Kay and Crnogorac, Matija and Delbarba, Elisa and Eller, Kathrin and Faguer, Stanislas and Galesic, Kresimir and Griffin, Siân and Hrušková, Zdenka and Jeyabalan, Anushya and Karras, Alexandre and King, Catherine and Kohli, Harbir Singh and Maas, Rutger and Mayer, Gert and Moiseev, Sergey and Muto, Masahiro and Odler, Balazs and Pepper, Ruth J. and Quintana, Luis F. and Radhakrishnan, Jai and Ramachandran, Raja and Salama, Alan D. and Segelmark, Mårten and Tesař, Vladimír and Wetzels, Jack and Willcocks, Lisa and Windpessl, Martin and Zand, Ladan and Zonozi, Reza and Kronbichler, Andreas},
  issn         = {1568-9972},
  language     = {eng},
  number       = {11},
  publisher    = {Elsevier},
  series       = {Autoimmunity Reviews},
  title        = {Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown?},
  url          = {http://dx.doi.org/10.1016/j.autrev.2020.102671},
  doi          = {10.1016/j.autrev.2020.102671},
  volume       = {19},
  year         = {2020},
}