Use of Rituximab in children with steroid- and calcineurin-inhibitor-dependent idiopathic nephrotic syndrome

Here we present long-term follow-up data from children with INS dependent on both prednisone and calcineurin-inhibitors for at least one year and in remission for at least six months. Consecutive children with these characteristics were treated with one or more rituximab infusions (up to 5) following the completion of a published clinical trial17, either because they had signs of toxicity from prednisone or calcineurin inhibitors, or to prevent toxicity following treatment for at least one year. We conducted clinical and vitro studies to describe: (1) the probability of maintaining disease remission for 6 and 12 months following rituximab infusion and prednisone and calcineurin-inhibitor withdrawal; (2) the risk of disease relapse in children who remained in remission following rituximab infusion and prednisone and calcineurin-inhibitor withdrawal; (3) the toxicity profile of repeated rituximab infusions; and (4) the relationship between variation in FcyR, CD20 and/or SMPDL-3B polymorphisms and response to rituximab.