Introduction

Rituximab is currently used after the conventional agents have failed in the management of steroid dependent (SD)/ steroid resistant (SR) podocytopathies and have a safer toxicity profile. We report 53 adults with podocytopathies who were managed effectively with CD19â€Âtargeted rituximab therapy.

Methods

This was a prospective study carried out at a tertiary care centre in India between January 2014 to June 2019. Adults between 16â€Â60èˆÂyears with SD, frequently relapsing (FR), and SR nephrotic syndrome (NS) due to podocytopathy received rituximab in a CD19â€Âtargeted approach. Primary outcome: Percentage of patients who were in remission at 6 and 12 months. Secondary outcome: Percentage of patients in remission at the last followâ€Âup, rituximab dose and adverse events of rituximab therapy.

Results

Fiftyâ€Âthree adults with SD/FR/SR NS received CD19â€Âtargeted rituximab. The median age at the time of first rituximab injection was 30.09 13.21 (16,53) years. At the time of first rituximab infusion, all patients were in remission with steroids and/or CNIs. Fifty (94.33%) patients were in remission at the end of 6, 12 months and the last followâ€Âup (medianâ€Â 36 months). The mean total dose of rituximab at 1â€Âyear was 788.7 128.1 (6001100) mg. At last followâ€Âup (median 36 months), 42 (79%) patients did not require any additional CNI or steroids therapy. No serious adverse events to rituximab was noted.

Conclusion

CD19â€Âtargeted rituximab therapy is safe and efficacious in the management of SD/SR adult podocytopathy. Also, rituximab is effective in maintaining remission in treatment naïve adult SD or FR podocytopathy.

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