Rituximab,effectiveness in idiopathic steroid-resistant or cortico-dependet nephrotic syndrome in patients under 18 years old, Barranquilla,2010-2013

Abstract

Objective: Determine the effectiveness of rituximab in idiopathic steroid-resistant or cortico-dependent nephrotic syndrome in patients under 18 years old, Barranquilla, 2010-2013. Materials and Methods: Multicenter clinical trial in patients with idiopathic steroid-resistant or cortico-depen- dent nephrotic syndrome with poor response to immunosuppressive in three hospitals. Therapeutic scheme was used with two doses of rituximab 500 mg/m2 every 15 days and at 6 months ransom; monitoring was performed every three months to 12 months. The information was systematized using the Epi-Info 3.5.3. Results: Predominance of males (64 % vs 36 %), the age ranges that had the highest frequency were: 6-10 years (43 %) and 11-15 years (43 %), edema was the presentation in 57 % of the sample, proteinuria in 43 %; the most common histological diagnosis was focal glomerular sclerosis and segmental (86 %) 100 % income nephrotic range. At 6 months after starting rituximab nephrotic frequency was 36 %, and 12 months was 7 % (6 months: OR = 0.005, CI = 0.00004 to 0.43, p = 0.0003; 12 months: OR = 0.0006, CI = 0.0001 to 0.06, p <0.00001); at 6 months was complete remission in 72 % and partial in 14 %, was considered treatment failure in 14 % at 12 months, there was complete remission in 93 % and treatment failure in 7 %. Conclusion: Rituximab 500 mg/m2 every 15 days for two doses and rescue to 6 months showed high efficacy in steroid-resistant or cortico-dependent nephrotic syndrome patients.