Rituximab improves the control of pediatric nephrotic syndrome and reduces healthcare utilization

Background Rituximab (RTX) is often used in children with nephrotic syndrome (NS), but there is lack of consensus on its dose among pediatric nephrologists. This study aimed to assess its efficacy in controlling NS and impact on healthcare utilization in children with NS.Materials and methods This is a retrospective multicenter study of children with primary NS who were treated with RTX between 2013 and 2017. Summary statistics were used to describe the data. Variables were analyzed using Fisher's exact test or Mann-Whitney U test where indicated.Results The study included 50 children from 6 centers. At 12 months, 71.5% of steroid-sensitive NS (SSNS) patients and 37.5% of steroid-resistant NS (SRNS) patients achieved sustained remission. The median time to relapse was 16 months for the SSNS group and 7 months for the SRNS group. The median time to relapse was 7 months when receiving 1 infusion vs. 17 months for those receiving 2 RTX infusions. The rate of hospital admissions per patient-year significantly decreased from 0.53 to 0.11 after RTX treatment, without an increase in infection-related admissions.Conclusion RTX is largely an effective treatment in children with SSNS leading to long remission periods and a substantial decrease in hospitalizations, with a low risk of serious infections.