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

Gauckler, P; Shin, JI; Alberici, F; Audard, V; Bruchfeld, A; Busch, M; Cheung, CK; ... RITERM study group, .; + view all (2020) Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown? Autoimmunity Reviews , Article 102671. 10.1016/j.autrev.2020.102671. (In press). Green open access

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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.

Type: Article
Title: Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - What is known and what is still unknown?
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.autrev.2020.102671
Publisher version: https://doi.org/10.1016/j.autrev.2020.102671
Language: English
Additional information: This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Keywords: Nephrotic syndrome, Rituximab, Minimal change disease, Focal segmental glomerulosclerosis, Long-term remission, Infections
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10111038
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