Review of the Role of Rituximab in the Management of Adult Minimal Change Disease and Immune-Mediated Focal and Segmental Glomerulosclerosis
dc.contributor.author | Aslam, Ahsan | |
dc.contributor.author | Koirala, Abbal | |
dc.contributor.department | Medicine, School of Medicine | |
dc.date.accessioned | 2024-03-27T13:52:21Z | |
dc.date.available | 2024-03-27T13:52:21Z | |
dc.date.issued | 2023-08-18 | |
dc.description.abstract | Background: 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. | |
dc.eprint.version | Final published version | |
dc.identifier.citation | Aslam 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:10.1159/000533695 | |
dc.identifier.uri | https://hdl.handle.net/1805/39551 | |
dc.language.iso | en_US | |
dc.publisher | Karger | |
dc.relation.isversionof | 10.1159/000533695 | |
dc.relation.journal | Glomerular Diseases | |
dc.rights | Attribution-NonCommercial 4.0 International | en |
dc.rights.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.source | PMC | |
dc.subject | Rituximab | |
dc.subject | Nephrotic syndrome | |
dc.subject | Minimal change disease | |
dc.subject | Focal and segmental glomerulosclerosis | |
dc.subject | Complete remission | |
dc.subject | Partial remission | |
dc.subject | Steroid-dependent nephrotic syndrome | |
dc.subject | Steroid-resistant nephrotic syndrome | |
dc.subject | Corticosteroids | |
dc.subject | Calcineurin inhibitors | |
dc.subject | Urine protein-to-creatinine ratio | |
dc.title | Review of the Role of Rituximab in the Management of Adult Minimal Change Disease and Immune-Mediated Focal and Segmental Glomerulosclerosis | |
dc.type | Article |