ArticlePediatric nephrology (Berlin, Germany)2026
B cell depletion with rituximab in children with steroid-sensitive nephrotic syndrome: does depletion duration change outcome?
Article in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- When should sequential rituximab therapy for long-term B-cell depletion be initiated in children with steroid-sensitive nephrotic syndrome?Pediatric nephrology (Berlin, Germany) · 2026Article
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8 authors.
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Abstract
backgroundRituximab (RTX) is widely used to prevent relapses in steroid-dependent or frequently-relapsing nephrotic syndrome (SD/FRNS). However, the impact of B-cell depletion duration on long-term outcomes remains uncertain. We compared short-term B-cell depletion (limited RTX course) with prolonged depletion maintained by repeated RTX infusions and assessed long-term disease activity.
methodsIn this retrospective multicenter study, we included children with SD/FRNS who received RTX before the age of 18 years between 2007 and 2017. Short-depletion corresponded to one or two RTX infusions, whereas prolonged-depletion reflected repeated infusions over time to maintain B-cell depletion. Prolonged remission was defined as the absence of relapse and immunosuppressive therapy for at least 2 years after the last anti-CD20 infusion.
resultsA total of 117 patients were included (median age at first RTX infusion: 11.6 years; 65% were boys), of whom 48 (41%) had short-depletion and 69 (59%) had prolonged-depletion. Baseline characteristics were comparable between groups. At 2 years after the last RTX infusion, 69% of patients in the short-depletion group and 65% in the prolonged-depletion group were in prolonged remission. Overall, 89 patients (75%) relapsed during follow-up. Median time to first relapse was significantly longer in the long-depletion group (36 vs. 19 months, p = 0.04). Prolonged hypogammaglobulinemia was more frequent with prolonged-depletion, whereas infection rates were similar between groups.
conclusionRTX exerts a suspensive rather than curative effect in SD/FRNS. Prolonged B-cell depletion extends relapse-free survival but is associated with more frequent hypogammaglobulinemia, without an increase in severe infections.
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