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

for the RITERM study group

Research output: Contribution to journalReview articlepeer-review

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 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.

Original languageEnglish (US)
Article number102671
JournalAutoimmunity Reviews
Volume19
Issue number11
DOIs
StatePublished - Nov 2020

Keywords

  • Focal segmental glomerulosclerosis
  • Infections
  • Long-term remission
  • Minimal change disease
  • Nephrotic syndrome
  • Rituximab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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