ArticlePediatric nephrology (Berlin, Germany)2026
The impact of anti-rituximab antibodies on rituximab efficacy in children with frequently relapsing or steroid-dependent nephrotic syndrome.
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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.
Who cites it
2 citing papers in PubMed.
- Limitations in assessing genotype-phenotype correlations in pediatric dent disease.Pediatric nephrology (Berlin, Germany) · 2026Article
- Incidence and implications of anti-rituximab antibodies in nephropathies and other immune-mediated diseases: a narrative review.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundRituximab (RTX), a chimeric human-murine monoclonal antibody, is an established therapeutic agent for children with frequently relapsing or steroid-dependent nephrotic syndrome (FRNS/SDNS). However, RTX-induced immunogenicity, characterized by the production of anti-rituximab antibodies (ARA), might compromise the therapeutic efficacy of RTX and alter its safety profile. To date, the impact of ARA on RTX pharmacokinetics, clinical efficacy, and safety in this specific pediatric population remains not fully elucidated.
methodsThis retrospective study included 33 children with FRNS/SDNS categorized by ARA status (16 positive and 17 negative). We compared RTX concentrations, CD19⁺ B-cell depletion kinetics (Kaplan-Meier/Cox models), clinical outcomes (relapses, UACR), and safety between groups. The associations between ARA titers, drug levels, and therapeutic efficacy were analyzed using Spearman's correlation and multivariate linear regression.
resultsThe ARA positivity rate was 48.5%. ARA-positive patients exhibited significantly lower median RTX concentrations than ARA-negative patients (20.48 vs. 52.85 μg/mL, P < 0.001), with RTX levels negatively correlating with ARA titers (ρ = - 0.875, P < 0.001). Multivariate regression identified ARA positivity as an independent predictor of reduced RTX exposure (β = - 26.89, P < 0.001). Furthermore, the ARA-positive group showed significantly shorter B-cell depletion (58.5 vs. 163 days, P < 0.001; HR = 6.11), more frequent relapses at 12 months (P = 0.004), and higher cumulative RTX treatments (P = 0.043). No significant differences in safety profiles were observed (P > 0.05).
conclusionARA positivity is common in pediatric FRNS/SDNS. The presence of ARA is associated with lower RTX serum levels, shortened B-cell depletion duration, and increased risk of relapse, but it does not significantly impact treatment safety. Routine monitoring of ARA status should be considered to guide individualized RTX therapy and optimize outcomes.
Indexed as
Identifiers
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Registered trials
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.