Aslam, AhsanKoirala, Abbal2024-03-272024-03-272023-08-18Aslam A, Koirala A. Review of the Role of Rituximab in the Management of Adult Minimal Change Disease and Immune-Mediated Focal and Segmental Glomerulosclerosis. Glomerular Dis. 2023;3(1):211-219. Published 2023 Aug 18. doi:10.1159/000533695https://hdl.handle.net/1805/39551Background: Minimal change disease and primary FSGS are podocytopathies but are also immune-mediated diseases. Rituximab acts via multiple mechanisms by tilting the balance between autoreactive B and T cells in favor of regulatory B and T cells. The consequences are decreased production of cytokines, chemokines, and permeability factors by these cells. In the past decade, we have seen the discovery of autoantibodies mediating nephrotic syndrome (anti-annexin A2 antibody, anti-UCHL1 antibody, and anti-nephrin antibody), and rituximab decreases their production. Rituximab also binds to podocyte SMPDL3b and has direct podocyte actions. Summary: Rituximab's role in managing these primary podocytopathies has been discussed in this brief review. Rituximab has been used extensively in children and adults with frequently relapsing and steroid-dependent nephrotic syndrome. However, rituximab is not very promising in adult steroid-resistant nephrotic syndrome. Although ofatumumab would cause prolonged B-cell depletion and is fully humanized, it is unclear if it is superior to rituximab in preventing relapse of nephrotic syndrome. Key messages: Rituximab therapy can induce prolonged remission in adults with frequently relapsing and steroid-dependent nephrotic syndrome. However, no good data exist on using rituximab in steroid-resistant nephrotic syndrome.en-USAttribution-NonCommercial 4.0 InternationalRituximabNephrotic syndromeMinimal change diseaseFocal and segmental glomerulosclerosisComplete remissionPartial remissionSteroid-dependent nephrotic syndromeSteroid-resistant nephrotic syndromeCorticosteroidsCalcineurin inhibitorsUrine protein-to-creatinine ratioArticle