{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:47:41Z","timestamp":1782920861797,"version":"3.54.5"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Youth Research Fund","award":["2021QN06"],"award-info":[{"award-number":["2021QN06"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rituximab (RTX) is effective for pediatric frequently-relapsing or steroid-dependent nephrotic syndrome (FR\/SDNS); however, some patients develop RTX resistance or severe hypersensitivity. Ofatumumab (OFA), a fully humanized anti-CD20 monoclonal antibody, represents a potential alternative, yet its use in children remains poorly documented. This study evaluates the feasibility and safety of low-dose subcutaneous (SC) OFA in children with complicated FR\/SDNS who are RTX resistant or intolerant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed five pediatric patients (median age 14.8 years) with FR\/SDNS and a history of RTX resistance or hypersensitivity. Each patient received a standardized SC OFA dose of 20\u00a0mg. B-cell depletion (CD19\u207a &amp;lt;1%), serum IgG levels, and adverse events\u2014graded according to the Common Terminology Criteria for Adverse Events (CTCAE)\u2014were monitored throughout follow-up. The primary endpoint was relapse-free remission within 12 months of the last OFA dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>SC OFA achieved peripheral B-cell depletion in all patients, with a median duration of 5 months. Within 12 months, 80% (4\/5) of patients maintained remission. One patient with previous severe anti-CD20 hypersensitivity tolerated SC OFA with mild (Grade 2) symptoms after ibuprofen premedication. No severe infections or exacerbations of hypogammaglobulinemia were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low-dose SC OFA is a feasible preemptive therapy for remission maintenance in pediatric FR\/SDNS, particularly for those with RTX resistance or intolerance. This outpatient-compatible route may reduce hypersensitivity risks and healthcare costs. Larger prospective trials are warranted to confirm long-term efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfag169","type":"journal-article","created":{"date-parts":[[2026,5,24]],"date-time":"2026-05-24T11:35:39Z","timestamp":1779622539000},"source":"Crossref","is-referenced-by-count":0,"title":["Subcutaneous ofatumumab for remission maintenance in pediatric idiopathic nephrotic syndrome: a case series"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0590-9359","authenticated-orcid":false,"given":"Ning-Xun","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Yi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ru-Yue","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Zhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Immunology in Children\u2019s Hospital of Soochow University , Suzhou, Jiangsu ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"2026070105015270600_bib1","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1007\/s00467-020-04519-1","article-title":"IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome","volume":"35","author":"Trautmann","year":"2020","journal-title":"Pediatr Nephrol"},{"key":"2026070105015270600_bib2"},{"key":"2026070105015270600_bib3","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1681\/ASN.2021050643","article-title":"Mycophenolate mofetil after rituximab for childhood-onset complicated frequently-relapsing or steroid-dependent nephrotic syndrome","volume":"33","author":"Iijima","year":"2022","journal-title":"J Am Soc Nephrol"},{"key":"2026070105015270600_bib4","doi-asserted-by":"publisher","first-page":"805697","DOI":"10.3389\/fimmu.2022.805697","article-title":"New and old anti-CD20 monoclonal antibodies for nephrotic syndrome. 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