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Cyclophosphamide and rituximab in frequently relapsing/steroid-dependent nephrotic syndrome
| Content Provider | Semantic Scholar |
|---|---|
| Author | Webb, Hazel Jaureguiberry, Graciana Dufek, Stephanie Tullus, Kjell Bockenhauer, Detlef |
| Copyright Year | 2015 |
| Abstract | BackgroundSteroid-sensitive nephrotic syndrome is the most common form of nephrotic syndrome in childhood, defined by the response to treatment with glucocorticoids with consequent remission. While most children eventually experience spontaneous resolution of the disease, some have a difficult course with frequent relapses or steroid dependence nephrotic syndrome (FRSDNS). The consequent steroid toxicity often prompts administration of other immunosuppressive drugs, traditionally cyclophosphamide. Recently, rituximab has been reported as effective in this disorder, but long-term experience is lacking.MethodsRetrospective note review of all children with FRSDNS treated with a first course of cyclophosphamide and/or rituximab in our center between December 2006 and April 2015. We reviewed time to first relapse after treatment, co-medications, and side effects.ResultsA total of 102 children were treated with cyclophosphamide (79) and/or rituximab (42). Of these, 34 received cyclophosphamide prior to rituximab. Median time to first relapse was 7 months after cyclophosphamide and 14 months after rituximab. Documented side effects of cyclophosphamide included neutropenia, hair loss, and hemorrhagic cystitis (1). Rituximab was associated with an allergic reaction at infusion in two patients.ConclusionsRituximab was used in children with the most difficult to treat FRSDNS, yet was associated with longer remission time and less side effects than cyclophosphamide. A randomized controlled trial is needed to directly compare these drugs. |
| Starting Page | 589 |
| Ending Page | 594 |
| Page Count | 6 |
| File Format | PDF HTM / HTML |
| DOI | 10.1007/s00467-015-3245-9 |
| PubMed reference number | 26525199 |
| Journal | Medline |
| Volume Number | 31 |
| Alternate Webpage(s) | https://discovery.ucl.ac.uk/id/eprint/1483441/1/Bockenhauer_CvsR%20submit%2020150930rev1clean.pdf |
| Alternate Webpage(s) | https://doi.org/10.1007/s00467-015-3245-9 |
| Journal | Pediatric Nephrology |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
