Efficacy and Safety of rituximab in children with difficult-to-treat nephrotic syndrome; A systematic review

Azarfar, A. and Ravanshad, Y. and Mehrad-Majd, H. and Aval, S. B. and Nastarani, S. and Emadzadeh, M. and Khazaei, M. R. and Fazel, M. and Azimi, B. (2018) Efficacy and Safety of rituximab in children with difficult-to-treat nephrotic syndrome; A systematic review. Journal of Renal Injury Prevention, 7 (4). pp. 307-313.

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Abstract

To date, several studies have been done on efficacy and safety of drugs in children with refractory nephrotic syndrome (NS). Rituximab (RTX) might be a hopeful treatment for this syndrome. However, the long-term effects and cost-effectiveness of RTX treatment were not fully assessed. This study aims to do a systematic review about the efficacy and safety of RTX in children with difficult-to-treat NS. For this research, an electronic literature search was conducted to identify appropriate investigations. The search term was ("nephrotic syndrome" or "minimal change disease" or "focal segmental glomerulosclerosis" or membranous) and (''rituximab'' or ''CD20''). We included all randomized trials and observational studies about using RTX in children with difficult-to-treat NS. Two independent reviewers extracted data from the papers according to the selection criteria. Eligible studies were included in this systematic review. The literature search and reference mining yielded 919 potential relevant papers. We removed 340 articles because of duplication. We also excluded 513 papers after reviewing the titles and abstracts. Finally, 17 studies were included in the systematic review. Efficacy of RTX in children with NS in most of the studies was assessed with relapse-free survival or complete remission rates. Acknowledging the limitations of the study due to the size and nature of the studies included, our systematic review shows that RTX was effective in the treatment of refractory NS in children, and it could reduce the use of steroid and immunosuppressants. However, further large randomized trials are suggested. © 2018 The Author(s).

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Ravanshad, Y.; Clinical Research Unit, Mashhad University of Medical SciencesIran; email: yalda.ravanshad@gmail.com
Uncontrolled Keywords: Children Dyslipidemia Hypoalbuminemia Hypercoagulability Nephrotic syndrome Proteinuria Rituximab Treatment
Subjects: WJ Urogenital System
WS Pediatrics
Divisions: Mashhad University of Medical Sciences
Depositing User: lib2 lib2 lib2
Date Deposited: 08 Jun 2020 05:07
Last Modified: 08 Jun 2020 05:07
URI: http://eprints.mums.ac.ir/id/eprint/17217

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