Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study

Background/aim: This study aimed to evaluate the efficacy of rituximab in children with difficult-to-treat nephrotic syndrome, considering the type of disease (steroid-sensitive or –resistant) and the dosing regimen. Materials and methods: This multicenter retrospective study enrolled children with difficult-to-treat nephrotic syndrome on rituximab treatment from 13 centers. The patients were classified based on low (single dose of 375 mg/m2) or high (2-4 doses of 375 mg/m2) initial dose of rituximab and the steroid response. Clinical outcomes were compared. Results: Data from 42 children [20 steroid-sensitive (frequent relapsing / steroid-dependent) and 22 steroid-resistant nephrotic syndrome, aged 1.9–17.3 years] were analyzed. Eleven patients with steroid-sensitive nephrotic syndrome (55%) had a relapse following initial rituximab therapy, with the mean time to first relapse of 8.4 ± 5.2 months. Complete remission was achieved in 41% and 36% of steroid-resistant patients, with the median remission time of 3.65 months. At Year 2, eight patients in steroid-sensitive group (40%) and four in steroid-resistant group (18%) were drug-free. Total cumulative doses of rituximab were higher in steroid-resistant group (p = 001). Relapse rates and time to first relapse in steroid-sensitive group or remission rates in steroid-resistant group did not differ between the low and high initial dose groups. Conclusion: The current study reveals that rituximab therapy may provide a lower relapse rate and prolonged relapse-free survival in the steroid-sensitive group, increased remission rates in the steroid-resistant group, and a significant number of drug-free patients in both groups. The optimal regimen for initial treatment and maintenance needs to be determined.Key words: Frequently relapsing nephrotic syndrome, immunosuppressive agents, steroid-dependent nephrotic syndrome, steroidresistant nephrotic syndrome, remission

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APA	Taşdemir M, Canpolat N, Yıldız N, Özçelik G, BENZER M, Saygili S, Ozkayin E, Türkkan Ö, BALAT A, Candan C, çelakıl m, Yavuz S, AKINCI N, Goknar N, AKGUN C, ALPAY H, Sever F, Bilge I (2021). Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. , 1781 - 1790. 10.3906/sag-2012-297
Chicago	Taşdemir Mehmet,Canpolat Nur,Yıldız Nurdan,Özçelik Gül,BENZER MERYEM,Saygili Seha Kamil,Ozkayin Emine Nese,Türkkan Özde nisa,BALAT AYSE,Candan Cengiz,çelakıl mehtap,Yavuz Sevgi,AKINCI NURVER,Goknar Nilufer,AKGUN CIHANGIR,ALPAY HARİKA,Sever Fatma lale,Bilge Ilmay Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. (2021): 1781 - 1790. 10.3906/sag-2012-297
MLA	Taşdemir Mehmet,Canpolat Nur,Yıldız Nurdan,Özçelik Gül,BENZER MERYEM,Saygili Seha Kamil,Ozkayin Emine Nese,Türkkan Özde nisa,BALAT AYSE,Candan Cengiz,çelakıl mehtap,Yavuz Sevgi,AKINCI NURVER,Goknar Nilufer,AKGUN CIHANGIR,ALPAY HARİKA,Sever Fatma lale,Bilge Ilmay Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. , 2021, ss.1781 - 1790. 10.3906/sag-2012-297
AMA	Taşdemir M,Canpolat N,Yıldız N,Özçelik G,BENZER M,Saygili S,Ozkayin E,Türkkan Ö,BALAT A,Candan C,çelakıl m,Yavuz S,AKINCI N,Goknar N,AKGUN C,ALPAY H,Sever F,Bilge I Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. . 2021; 1781 - 1790. 10.3906/sag-2012-297
Vancouver	Taşdemir M,Canpolat N,Yıldız N,Özçelik G,BENZER M,Saygili S,Ozkayin E,Türkkan Ö,BALAT A,Candan C,çelakıl m,Yavuz S,AKINCI N,Goknar N,AKGUN C,ALPAY H,Sever F,Bilge I Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. . 2021; 1781 - 1790. 10.3906/sag-2012-297
IEEE	Taşdemir M,Canpolat N,Yıldız N,Özçelik G,BENZER M,Saygili S,Ozkayin E,Türkkan Ö,BALAT A,Candan C,çelakıl m,Yavuz S,AKINCI N,Goknar N,AKGUN C,ALPAY H,Sever F,Bilge I "Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study." , ss.1781 - 1790, 2021. 10.3906/sag-2012-297
ISNAD	Taşdemir, Mehmet vd. "Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study". (2021), 1781-1790. https://doi.org/10.3906/sag-2012-297

APA	Taşdemir M, Canpolat N, Yıldız N, Özçelik G, BENZER M, Saygili S, Ozkayin E, Türkkan Ö, BALAT A, Candan C, çelakıl m, Yavuz S, AKINCI N, Goknar N, AKGUN C, ALPAY H, Sever F, Bilge I (2021). Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. Turkish Journal of Medical Sciences, 51(4), 1781 - 1790. 10.3906/sag-2012-297
Chicago	Taşdemir Mehmet,Canpolat Nur,Yıldız Nurdan,Özçelik Gül,BENZER MERYEM,Saygili Seha Kamil,Ozkayin Emine Nese,Türkkan Özde nisa,BALAT AYSE,Candan Cengiz,çelakıl mehtap,Yavuz Sevgi,AKINCI NURVER,Goknar Nilufer,AKGUN CIHANGIR,ALPAY HARİKA,Sever Fatma lale,Bilge Ilmay Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. Turkish Journal of Medical Sciences 51, no.4 (2021): 1781 - 1790. 10.3906/sag-2012-297
MLA	Taşdemir Mehmet,Canpolat Nur,Yıldız Nurdan,Özçelik Gül,BENZER MERYEM,Saygili Seha Kamil,Ozkayin Emine Nese,Türkkan Özde nisa,BALAT AYSE,Candan Cengiz,çelakıl mehtap,Yavuz Sevgi,AKINCI NURVER,Goknar Nilufer,AKGUN CIHANGIR,ALPAY HARİKA,Sever Fatma lale,Bilge Ilmay Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. Turkish Journal of Medical Sciences, vol.51, no.4, 2021, ss.1781 - 1790. 10.3906/sag-2012-297
AMA	Taşdemir M,Canpolat N,Yıldız N,Özçelik G,BENZER M,Saygili S,Ozkayin E,Türkkan Ö,BALAT A,Candan C,çelakıl m,Yavuz S,AKINCI N,Goknar N,AKGUN C,ALPAY H,Sever F,Bilge I Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. Turkish Journal of Medical Sciences. 2021; 51(4): 1781 - 1790. 10.3906/sag-2012-297
Vancouver	Taşdemir M,Canpolat N,Yıldız N,Özçelik G,BENZER M,Saygili S,Ozkayin E,Türkkan Ö,BALAT A,Candan C,çelakıl m,Yavuz S,AKINCI N,Goknar N,AKGUN C,ALPAY H,Sever F,Bilge I Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study. Turkish Journal of Medical Sciences. 2021; 51(4): 1781 - 1790. 10.3906/sag-2012-297
IEEE	Taşdemir M,Canpolat N,Yıldız N,Özçelik G,BENZER M,Saygili S,Ozkayin E,Türkkan Ö,BALAT A,Candan C,çelakıl m,Yavuz S,AKINCI N,Goknar N,AKGUN C,ALPAY H,Sever F,Bilge I "Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study." Turkish Journal of Medical Sciences, 51, ss.1781 - 1790, 2021. 10.3906/sag-2012-297
ISNAD	Taşdemir, Mehmet vd. "Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study". Turkish Journal of Medical Sciences 51/4 (2021), 1781-1790. https://doi.org/10.3906/sag-2012-297