Evidence map›Paper›PMID 39595166›Full record

ArticleBiomedicines2024

Rituximab Administration to Treat Nephrotic Syndrome in Children: 2-Year Follow-Up.

Dmytro Ivanov, Lutz T Weber, Elena Levtchenko, Liudmyla Vakulenko, Mariia Ivanova, Iryna Zavalna, Yelizaveta Lagodych, Ninel Boiko

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Biomedicines, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. [Efficacy and safety of rituximab in children with refractory nephrotic syndrome].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026
    Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dmytro IvanovInstitute of Postgraduate Education, Bogomolets National Medical University, 01601 Kyiv, Ukraine.ORCID 0000-0003-2609-0051
Lutz T WeberGerman Society for Pediatric Nephrology, 10963 Berlin, Germany.
Elena LevtchenkoEmma Children Hospital Amsterdam, University Medical Centre, BA2 6HE Amsterdam, The Netherlands.
Liudmyla VakulenkoDepartment of Propaedeutics of Childhood Illnesses and Pediatrics 2, Dnipro State Medical University, 49489 Dnipro, Ukraine.ORCID 0000-0003-3823-6134
Mariia IvanovaEuropean Institute of Oncology IRCCS, 20139 Milan, Italy.ORCID 0000-0002-7636-1000
Iryna ZavalnaInstitute of Postgraduate Education, Bogomolets National Medical University, 01601 Kyiv, Ukraine.
Yelizaveta LagodychInstitute of Postgraduate Education, Bogomolets National Medical University, 01601 Kyiv, Ukraine.ORCID 0000-0002-1045-4482
Ninel BoikoRegional Children Hospital, 33027 Rivne, Ukraine.ORCID 0009-0006-8828-7385

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSteroid-sensitive nephrotic syndrome (SSNS) and steroid-resistant nephrotic syndrome (SRNS) significantly affect children's quality of life. There are frequent relapses in SSNS and progression in SRNS. IPNA guidelines suggest that monoclonal antibodies like rituximab (RTX) are promising treatments.

objectiveThis study aims to evaluate the long-term efficacy and safety of rituximab administration in children with SSNS, encompassing FRNS and SDNS, and SRNS over a two-year follow-up period, facilitating individualized management.

methodsWe conducted an open-label, multicenter, randomized, and patient-oriented study (RICHNESS), involving children aged 3-18 with SRNS (18) and SSNS (11) undergoing 2 years continuous RTX therapy. The primary outcome was complete/partial remission (CR/PR), as defined by IPNA/KDIGO guidelines, at 6, 12, 18, and 24 months on RTX; secondary outcomes included adverse events. Key endpoints included the estimated glomerular filtration rate (eGFR), the albumin-to-creatinine ratio (ACR), CD20 levels, IgG levels, and the incidence of infections. Kidney biopsies were performed in 94% of SRNS patients. RTX was administered every 6-9 months, depending on CD20 levels, IgG levels, and the presence of infections. The eGFR and ACR were assessed every 6 months.

resultsSome 31 children were selected for RTX treatment. Overall, 2 experienced severe allergic reactions, leading to their exclusion from the final analysis of 29 children. In the SSNS group, all children achieved and maintained complete remission within 2 years. Remission rates in the SRNS group ranged from 39% (RR 0.78; 95% CI: 16.4-61.4%, NNT 9) at the 6th month to 72% (RR 1.44; 95% CI: 51.5-92.9%) over the 2-year follow-up period due to continuous RTX therapy. The median duration of RTX use was 26.1 months, with a median cumulative dose of 1820 mg/m

conclusionsRTX was tolerated well, and proved highly effective as a steroid-sparing agent, offering potential in terms of stopping relapses and minimizing steroid-related side effects. It also demonstrated efficacy in slowing progression in SRNS, indicating potential for use in ACR reduction and renal function restoration, but requires careful use given potential severe allergic reactions and infectious complications. Further studies should focus on long-term cost-effectiveness and deferred side effects.

Indexed as

B-cell depletion therapypediatric nephrotic syndromerituximabSRNSSSNS

Identifiers

PMID39595166
PMCPMC11592163

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.