Some case reports have suggested that rituximab can effectively treat nephrotic syndrome, and a recent study sought to assess the safety and effectiveness of rituximab in treating patients who have steroid- and cyclosporine-resistant pediatric nephrotic syndrome.
Idiopathic nephrotic syndrome, which is characterized by edema, hypoalbuminemia, proteinuria, and hyperlipemia, is the most prevalent chronic glomerular disease in childhood. Although the disease can often be treated successfully with steroids, approximately 10% to 20% of patients develop resistance to steroid therapy. These patients may be treated with cyclosporine, but this therapy is associated with toxicity, and patients may also have disease resistant to cyclosporine. Therefore, identifying alternative treatments is critical for this group of patients.
Some case reports have suggested that rituximab can effectively treat nephrotic syndrome, and a recent study sought to assess the safety and effectiveness of rituximab in treating patients who have steroid- and cyclosporine-resistant pediatric nephrotic syndrome. The study included patients at Tehran, Iran’s Ali Asghar Children’s Hospital who were younger than 18 years and had steroid- and cyclosporine-resistant or steroid- and cyclosporine-dependent nephrotic syndrome between 2014 and 2015.
The primary endpoint of the study was treatment response. A complete response was defined as no proteinuria, and a partial response was defined as a reduction of more than 50% in protein in the patient’s 24-hour urine sample from the beginning of treatment until 3 months after the last dose.
In total, 40 patients received rituximab at a dose of 375 mg per m2 once per week for 4 weeks and were followed for up to 2 years; 23 had steroid- and cyclosporine-resistant disease, 7 had late drug-resistant nephrotic syndrome, and 10 had steroid- and cyclosporine-dependent disease.
The researchers found the following with respect to response to treatment with rituximab:
Adverse events were noted in 4 patients: 2 had leukopenia, 1 had alopecia, and 1 had eosinophila.
The researchers concluded that rituximab was effective in treating nephrotic syndrome, and was well tolerated. “In fact,” wrote the authors, “this medication can be administered with full confidence because of its high clinical efficacy, minimized drug-related side effects, and also reduced recurrence, especially in those children with steroid- and cyclosporine- dependent nephrotic syndrome.”
Reference
Hoseni R, Sabzian K, Otukesh H, et al. Efficacy and safety of rituximab in children with steroid- and cyclosporine-resistant and steroid- and cyclosporine-dependent nephrotic syndrome. Iran J Kidney Dis. 2018;12(1):27-32. http://www.ijkd.org/index.php/ijkd/article/view/3317/982. Published January 2018. Accessed February 12, 2018.
Physician and Patient Perspectives After Starting or Switching to Amgevita in IBD
March 23rd 2024A real-world study surveying physicians and patients on adalimumab biosimilar ABP 501 (Amgevita) in inflammatory bowel disease (IBD) found both patients initiating ABP 501 and those who had switched from the reference product had higher satisfaction levels.
What AmerisourceBergen's Report Reveals About Payers, Biosimilar Pricing Trends
May 28th 2023On this episode of Not So Different, Tasmina Hydery and Brian Biehn from AmerisourceBergen discussed results from a recent survey, that were also presented at Asembia 2023, diving into the payer perspective on biosimilars and current pricing trends across the US biosimilar industry.
The Role of Biosimilars: Advancing Access, Financial Health, and System Sustainability
March 11th 2024Kashyap Patel, MD, CEO of Carolina Blood and Cancer Care, a member of the Community Oncology Alliance, and member of The Center for Biosimilars® Advisory Board, glances back at the development of the biosimilar industry and the last 5 years of progress.
Pipelines and Preparation: How the US Can Prepare for More RA Biosimilars
April 16th 2023What can practices do to prepare for all the biosimilars to treat rheumatoid arthritis (RA) coming down the pipeline? And how can they ensure that the lower-than-anticipated adoption rates for infliximab biosimilars are not repeated? Robert Zutaut, RPh, from McKesson Provider Solutions, tackles all this and more on this episode of Not So Different.
Cardinal Health Report Showcases Biosimilar Growth, Provider and Payer Evolution, and More
February 29th 2024In its annual biosimilars report, Cardinal Health provided updates on how provider acceptance growth, evolving payer dynamics, and the growing pipeline for biosimilars will shape the biosimilar landscape over the next 5 years.
Biosimilar Substitution Within OCM Could Result in Lower Total Cost of Care
February 16th 2024Researchers found that the total cost of care per oncology episode was significantly lowered when biosimilar substitution was implemented in Medicare’s Oncology Care Model (OCM), suggesting that biosimilar uptake can serve as a critical tool to mitigate risk and improve financial performance for providers.