Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Gauckler, P; Matyjek, A; Kapsia, S; Marinaki, S; Quintana, LF; Diaz, MM; King, C; Griffin, S; Ramachandran, R; Odler, B; Eller, K; Artan, AS; Mirioglu, S; Busch, M; Schaepe, M; Turkmen, K; Cheung, CK; Pepper, RJ; Juarez, GF; Pascual, J; Auñón, P; García-Carro, C; Rodriguez, A; Alberici, F; Luzardo, L; Chebotareva, N; Schönermarck, U; Fernández, L; Radhakrishnan, J; Guaman, K; Peleg, Y; Hoisnard, L; Audard, V; Papasotiriou, M; Krnanska, N; Tesar, V; Hruskova, Z; Bruchfeld, A; Stangou, M; Lioulios, G; Faguer, S; Ribes, D; Salhi, S; Windpessl, M; Galešić, K; Crnogorac, M; Zagorec, N; Mayer, G; Kronbichler, A, , RITERM, Study, Team.
Long-Term Outcomes of Rituximab-Treated Adult Patients with Podocytopathies.
J Am Soc Nephrol. 2024;
Doi: 10.1681/ASN.0000000520
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PubMed
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- Co-Autor*innen der Med Uni Graz
- Eller Kathrin
- Odler Balazs
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- Abstract:
- BACKGROUND: Long-term outcomes of rituximab-treated adult patients with podocytopathies (either minimal change disease or focal segmental glomerulosclerosis) are largely unknown. METHODS: A retrospective study at 30 nephrology departments from 15 countries worldwide included rituximab-treated adults with primary podocytopathies and a minimum clinical follow-up of 36 months. The primary outcome was relapse-free survival at 36 months. RESULTS: 183 adult patients (n=64 with focal segmental glomerulosclerosis and n=119 with minimal change disease) with difficult-to-treat nephrotic syndrome (68% steroid-dependent/frequently relapsing, 22% steroid-resistant, 85% previously treated with two or more lines of immunosuppressive therapy) were treated with rituximab as part of a remission induction regimen. Complete or partial remission at 6 months after rituximab treatment was achieved in 82%. Eighty-three of 151 (55%) initial responders achieved long-term relapse-free survival over three years. Maintenance therapy with rituximab was associated with a better relapse-free survival (HR 2.05, 95% CI: 1.07-3.91), irrespective of the dosing regimen. At 36 months, 61% of initial responders receiving maintenance therapy with rituximab achieved long-term relapse-free survival and withdrawal of all concomitant immunosuppressive medication compared to 36% of patients without maintenance treatment (OR 2.69, 95% CI: 1.27-5.73). Relapses per year were reduced from an annual relapse rate of 1.0 (95% CI: 1.0-1.7) before to 0.17 (95% CI: 0.00-0.24) relapses/year after rituximab initiation. Over the 36 months of follow-up, a stable course of estimated glomerular filtration rate (eGFR) was observed in those who initially responded with either complete or partial remission, whereas non-responders experienced a reduction in eGFR reaching -11 (95% CI: -18 to -8) mL/min/1.73m2 . CONCLUSIONS: Rituximab facilitated achievement of initial and long-term response in a majority of adult patients with difficult-to-treat podocytopathies. Maintenance treatment with rituximab further associated with long-term relapse-free survival over three years. Non-response to initial rituximab treatment was associated with poor kidney prognosis.
- Find related publications in this database (Keywords)
- nephrotic syndrome
- podocyte