ESPN 50th Annual Meeting

ESPN 2017


 
Efficacy of Two vs Four Doses of Rituximab Therapy for Childhood Nephrotic Syndrome
DEIRDRE HAHN 1 JILL FARQUHAR 1 Yvonne Koh 1

1- SYDNEY CHILDRENS HOSPITAL NETWORK - CHILDRENS HOSPITAL WESTMEAD
 
Introduction:

Traditionally treatment of steroid dependent and steroid resistant nephrotic syndrome with Rituximab has been four doses one week apart for a total of four doses.  We compare the efficacy of two versus for four doses as follows:  time to relapse; T & B cell count; recurrence of proteinuria; protein:creatine ratio; requirement of repeat courses.

 

Material and methods:

Twenty eight children between 38 months to 217 months of age received rituximab therapy. We reviewed patient histories, noting time to relapse; T & B cell count; recurrence of proteinuria; protein:creatine ratio; repeat courses.

Results:

Eleven children received the traditional course of 4 doses X 1 course, Seven children received 2 doses X 1 course, 2 children received 1 dose X 1 course, 1 child received three doses X 1 course.  The remaining seven children received multiple courses of between 1 and 4 doses. 

Conclusions:

There appeared to be no significant difference in outcomes between the 2 vs 4 dose regimes.  We recommend a reduction in rituximab regimes from four to two doses, thus reducing costs, potential adverse reactions to the drug, and inconvenience to children and their families.