A comparison of two and multiple doses of rituximab in pediatric patients with frequent relapses and steroid- dependent nephrotic syndrome. A single-center study

Author:

Roujouleh Farah1,Aleysae Nabil1,Alharbi Naffa1,Salem May1,Bamahmoud Alaa1,Bajamal Manal1,Kimawi Abdullah1,Almehmadi Alanoud1,Bawayan Rayan1

Affiliation:

1. King Faisal Specialist Hospital and Research Center- Jeddah

Abstract

Abstract

Aim. Compare the efficacy and safety of two different rituximab regimens in children suffering from frequently relapsing or steroid-dependent nephrotic syndrome (FR/SDNS). Methods. We included all pediatric patients diagnosed with FR/SDNS who received two or more doses of rituximab infusions and were followed up for at least 12 months from the initiation of therapy at a single referral center in Saudi Arabia between January 2010 and September 2021. Patients were categorized into two groups: those who received 2 doses (Group A) and those who received 3 or more doses (Group B) of rituximab therapy. The primary outcome was the proportion of patients maintaining remission at 6-, 10-, and 12-month intervals following the beginning of the first course of rituximab therapy. Result. The study included 28 patients, 13 (46.5%) in group A and 15 (53.5%) in group B. The average disease onset was 3 years old. Both groups achieved similar remission rates at various follow-up points (100% at 6 months, then decreasing over time). While relapse rates were similar, the time between relapses was longer in group B (86.6 weeks) compared to group A (55 weeks, p = 0.02). Minor side effects occurred in 6 patients (16%), but none were serious. Conclusion. While two doses of rituximab are comparable in effectiveness to multiple doses over a 12-month period, receiving more than two doses may significantly extend the duration of relapse-free survival.

Publisher

Research Square Platform LLC

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