Single dose rituximab in steroid dependent nephrotic syndrome and frequently relapsing nephrotic syndrome in children 2-18 years of age in a tertiary care hospital during a period of 1 year - a pre post study

Abstract

ABSTRACT Background: Nephrotic syndrome (NS) is a common pediatric kidney disorder, with many children developing frequently relapsing (FRNS) or steroid-dependent nephrotic syndrome (SDNS), leading to prolonged steroid use and associated complications. Rituximab, an anti-CD20 monoclonal antibody, offers a potential steroid-sparing alternative. This study evaluates the effectiveness of a single-dose rituximab regimen in children aged 2–18 years with FRNS and SDNS, focusing on improving remission rates, reducing steroid dependence, and enhancing cost-effectiveness. Objectives: Primary objective: To assess the sustained remission at 3 months post single dose rituximab in patients with steroid dependent nephrotic syndrome and frequently relapsing nephrotic syndrome Secondary objective:  To assess B-cell suppression by measuring CD 19 levels prior to rituximab then at 3 weeks and 3 months post single dose Rituximab.  To predict relapse by assessing for recovery of B cell at 3 weeks and 3 months post single dose Rituximab.