Rituximab Shows Long-Term Remission in Pediatric Steroid-Dependent Nephrotic Syndrome

BackgroundRituximab has been shown efficacy in reducing relapses among patients with steroid-dependent or frequently relapsing nephrotic syndrome (SDNS/FRNS), primarily due to minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS). However, whether its efficacy differs between these two histological subtypes remains unclear.MethodsA retrospective cohort study included 42 pediatric SDNS/FRNS patients with biopsy-proven MCD or FSGS. Clinical outcomes, including remission rates and relapse frequency were assessed.ResultsThe median age at diagnosis of the 42 patients was 5.1 years (IQR: 2.9–7.4), and 28 (67%) patients were male during the 6-year follow-up. Each patient received a median of 4 (IQR: 3–5) infusions. All patients achieved clinical remission, with 90.5% attaining complete remission. Relapse times decreased to 35.7% within 1 year after the first rituximab treatment, from a median of 2 relapses to 0. No significant difference in relapse rates was observed between patients receiving 3–4 doses versus 1–2 doses during the initial course. Histologically, 36 patients (85.7%) had MCD and 6 (14.3%) had FSGS. In the FSGS group, the 96-month relapse-free survival was higher compared to MCD controls (2/6 [33.3%] vs. 15/36 [41.7%]; p