ArticleClinical kidney journal2025
Subcutaneous ofatumumab in recurrent focal segmental glomerulosclerosis after kidney transplantation.
Article in Clinical kidney journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Anti-nephrin autoantibodies in post-transplant recurrence of focal segmental glomerulosclerosis: a review.Renal failure · 2026Review
- Targeting CD20 for B-cell Depletion in Autoimmune Kidney Disease: Next Generation.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2025Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Recurrent focal segmental glomerulosclerosis (rFSGS) is a severe condition occurring after kidney transplantation (KT) and has a high graft loss rate. Its incidence is reported as up to 55% of KTs, typically diagnosed within 1.5 months post-transplant. Treatment typically involves plasmapheresis, with adjunctive rituximab therapy, achieving partial or complete remission in up to 57% of patients. We report the case of a paediatric patient who experienced two episodes of rFSGS post-KT, presenting with acute kidney injury (AKI). The second episode was treated with subcutaneous ofatumumab with complete remission. Methods: The treatment protocol included four weekly plasmapheresis treatments, with Kesimpta administered subcutaneously at a dose of 20 mg twice weekly, given at the end of the plasmapheresis session. Plasmapheresis was then discontinued for 48-72 h following Kesimpta administration. CD20 levels were followed. Results: A KT patient experienced a second rFSGS, presenting with massive proteinuria of 13 g/day, 3 years post-transplant. Due to severe allergic reaction to rituximab during the first recurrence, she was treated with a combination of plasmapheresis and Kesimpta during the second episode. CD20 levels were undetected within two doses of Kesimpta treatment. Full remission and AKI resolved 1 month after initiation of this treatment. There were no severe adverse effects of the combined protocol. Conclusions: We propose a combination treatment of subcutaneous ofatumumab and intensive plasmapheresis, with CD19 and CD20 levels monitored regularly, might be safe and effective in rFSGS in KT patients.
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