Development of antirituximab antibodies in children with nephrotic syndrome

Yo Han Ahn, Hee Gyung Kang, Jiwon M. Lee, Hyun Jin Choi, Il Soo Ha, Hae Il Cheong

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Rituximab is actively used as a rescue therapy for nephrotic syndrome (NS). The development of antidrug antibodies, including antirituximab antibodies (ARA) and human antichimeric antibodies (HACA), is reported with rituximab treatment in various diseases. Here we report two pediatric patients with NS who developed ARA. Case diagnosis and treatment: Rituximab was given as a rescue therapy for two patients with steroid-dependent NS. Both patients had been treated orally with glucocorticosteroid, methylprednisolone, and calcineurin inhibitors but experienced frequent relapses. With rituximab treatment, the patients remained in remission for several months. After the B-cell count recovered, the patients received a second course of rituximab administration and experienced a hypersensitivity reaction during drug infusion. CD19 cell counts rose despite treatment with rituximab. ARA titers were monitored before and after rituximab treatment, and the development of ARA after the second course of rituximab administration was confirmed. Conclusions: We report the development of HACA in two patients with NS who did not achieve B-cell depletion after repeated administration of rituximab. This report suggests that additional studies are needed to determine the incidence of ARA in patients with NS, and its clinical significance.

Original languageEnglish
Pages (from-to)1461-1464
Number of pages4
JournalPediatric Nephrology
Volume29
Issue number8
DOIs
StatePublished - Aug 2014

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Nephrotic Syndrome
Antibodies
Therapeutics
B-Lymphocytes
Cell Count
Rituximab
Methylprednisolone
Human Development
Hypersensitivity
Steroids
Pediatrics
Recurrence
Incidence

Keywords

  • Human antichimeric antibody
  • Nephrotic syndrome
  • Rituximab

Cite this

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title = "Development of antirituximab antibodies in children with nephrotic syndrome",
abstract = "Background: Rituximab is actively used as a rescue therapy for nephrotic syndrome (NS). The development of antidrug antibodies, including antirituximab antibodies (ARA) and human antichimeric antibodies (HACA), is reported with rituximab treatment in various diseases. Here we report two pediatric patients with NS who developed ARA. Case diagnosis and treatment: Rituximab was given as a rescue therapy for two patients with steroid-dependent NS. Both patients had been treated orally with glucocorticosteroid, methylprednisolone, and calcineurin inhibitors but experienced frequent relapses. With rituximab treatment, the patients remained in remission for several months. After the B-cell count recovered, the patients received a second course of rituximab administration and experienced a hypersensitivity reaction during drug infusion. CD19 cell counts rose despite treatment with rituximab. ARA titers were monitored before and after rituximab treatment, and the development of ARA after the second course of rituximab administration was confirmed. Conclusions: We report the development of HACA in two patients with NS who did not achieve B-cell depletion after repeated administration of rituximab. This report suggests that additional studies are needed to determine the incidence of ARA in patients with NS, and its clinical significance.",
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Development of antirituximab antibodies in children with nephrotic syndrome. / Ahn, Yo Han; Kang, Hee Gyung; Lee, Jiwon M.; Choi, Hyun Jin; Ha, Il Soo; Cheong, Hae Il.

In: Pediatric Nephrology, Vol. 29, No. 8, 08.2014, p. 1461-1464.

Research output: Contribution to journalArticle

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