Immune drug doesn't help kids with hard-to-treat kidney disorder

The drug rituximab, an antibody that targets the immune system and is often used to treat immune disorders such as lymphoma and arthritis, has recently emerged as a potential treatment for a childhood kidney disorder known as idiopathic nephrotic syndrome (INS). While the cause of INS is not fully known, it is believed to be an immune disorder. Unfortunately, rituximab does not appear to benefit children who have INS that is resistant to standard treatments, according to a study appearing in an upcoming issue of new study in the Journal of the American Society of Nephrology (JASN).

INS has an estimated incidence of two to seven cases per 100,000 children and a prevalence of nearly 16 cases per 100,000. Children with the disease excrete large amounts of protein in their urine and exhibit other signs of kidney damage. Gian Marco Ghiggeri, MD (IRCCS Giannina Gaslini Children Hospital, in Genoa, Italy) and his colleagues recently reported that rituximab can successfully lower protein excretion in children with INS that responds to standard treatments consisting of steroids and called calcineurin inhibitors. Therefore, rituxmab may allow such patients to discontinue these potentially toxic medications.

A few anecdotal cases and small studies also suggest that rituximab may benefit children with INS that is unresponsive to standard treatments. To test this more rigorously, Ghiggeri and his team conducted the first of rituximab in 31 children with INS that did not respond to steroids and calcineurin inhibitors. All children in the study continued taking steroids and at the doses they took before they enrolled. Half of the patients also received two doses of rituximab.

After three months of treatment, rituximab did not reduce protein excretion in the urine.

By identifying which patients benefit from rituximab and which do not, "our work represents a step forward on the road to treating nephrotic syndrome in children," said Dr. Ghiggeri. However, the negative results of this latest study suggest that researchers and clinicians need a much better understanding of INS to develop effective therapies against cases that are resistant to standard treatment.

More information: The article, entitled "Rituximab in Children with Resistant Idiopathic Nephrotic Syndrome," will appear online on May 10, 2012, doi:10.1681/ASN.2011080775

add to favorites email to friend print save as pdf

Related Stories

Rituximab reduces kidney inflammation in patients with lupus

Mar 04, 2009

Treatment with the targeted drug rituximab can significantly benefit some patients with severe lupus nephritis who do not respond to conventional therapy, according to a study appearing in an upcoming issue of the Clinical Jo ...

Researchers’ blood cancer breakthrough

Aug 10, 2011

Researchers at the University of Southampton have discovered clues to why many patients do not respond to a standard drug for the blood cancer lymphoma, raising hopes that more effective treatments can be designed.

Time to stop giving toxic drugs to kidney transplant patients?

Sep 22, 2011

Patients who receive kidney transplants must take lifelong medications that, while preventing organ rejection, can also compromise other aspects of health. Immunosuppresive drugs called calcineurin inhibitors protect transplanted ...

Recommended for you

UN says Syria vaccine deaths was an NGO 'mistake'

48 minutes ago

The recent deaths of Syrian children after receiving measles vaccinations was the result of a "mistake" by a non-governmental partner who mixed in a muscle relaxant meant for anesthesia, a spokesman for the U.N. secretary-general ...

First US child dies from enterovirus D68

1 hour ago

A child in the northeastern US state of Rhode Island has become the first to die from an ongoing outbreak of a respiratory virus, enterovirus D68, health officials said Wednesday.

US Ebola patient had contact with kids: governor

1 hour ago

A man who was diagnosed with Ebola in virus in Texas came in contact with young children, and experts are monitoring them for any signs of disease, governor Rick Perry said Wednesday.

UN worker dies of suspected Ebola in Liberia

1 hour ago

The United Nations mission in Liberia announced on Wednesday the first suspected victim among its employees of the deadly Ebola epidemic ravaging the impoverished west African nation.

AAO-HNSF clinical practice guideline: Tinnitus

1 hour ago

The American Academy of Otolaryngology—Head and Neck Surgery Foundation has released the first ever mutli-disciplinary, evidence-based clinical practice guideline to improve the diagnosis and management of tinnitus, the ...

User comments