{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:30:48Z","timestamp":1777505448851,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Kidney Health Dis"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Adults with primary focal segmental glomerulosclerosis (FSGS) are frequently resistant to multiple immunosuppressive agents, which is associated with ongoing complications of nephrotic syndrome and a high risk of progression to end-stage renal disease (ESRD). Rituximab, a monoclonal antibody against the B cell CD20 antigen, has shown some preliminary evidence in treating nephrotic syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Describe the usage and the efficacy of rituximab for adults with FSGS in British Columbia (BC) (Canada) and perform a literature review of multi-immunosuppressive drug resistant FSGS in adult patients treated with rituximab to estimate the overall response rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Case series report and a literature review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients:<\/jats:title>\n                    <jats:p>For the case-series, all BC patients who received rituximab for a diagnosis of primary FSGS were included. The literature review included all cases of immunosuppressive-resistant FSGS patients treated with rituximab. We excluded transplant and pediatric patients in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We describe all cases of adults with native-kidney FSGS resistant to conventional immunosuppressive medications from our provincial health database who were treated with rituximab from 2014 to 2018. A review of the existing literature was performed via PubMed, MEDLINE, and Embase using the following keywords: rituximab, focal segmental glomerulosclerosis, and FSGS up to August 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We characterize four immunosuppressive-resistant FSGS patients who were treated with rituximab as part of our provincial program, all of whom showed a response to rituximab with a sustained remission. We found 29 specific cases in the literature of adults with native-kidney FSGS treated with rituximab after being resistant to other immunosuppressive medications, of whom 15 cases showed a response to rituximab. This has increased the total response rate from 15\/29 (52%) to 19\/33 (58%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations:<\/jats:title>\n                    <jats:p>Literature on this topic is coming predominantly from case series. Prospective trials are needed to confirm efficacy, tolerability, and duration of remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Due to the low number of currently reported cases and variable response rates, these four cases provide critical data to generate a more accurate understanding of the role of rituximab in adults with resistant FSGS. Adding these results to the confirmed literature cases of multiple-immunosuppressive-resistant FSGS patients treated with rituximab results in a total remission rate of 19\/33 cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20543581221090010","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T08:30:41Z","timestamp":1650357041000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Rituximab for Adults With Multi-Drug Resistant Focal Segmental Glomerulosclerosis: A Case Series and Review of the Literature"],"prefix":"10.1177","volume":"9","author":[{"given":"Ellia","family":"Zhong","sequence":"first","affiliation":[{"name":"The University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siavash","family":"Ghadiri","sequence":"additional","affiliation":[{"name":"The University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Pai","sequence":"additional","affiliation":[{"name":"The University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9317-8809","authenticated-orcid":false,"given":"Judith G.","family":"Marin","sequence":"additional","affiliation":[{"name":"The University of British Columbia, Vancouver, Canada"},{"name":"BC Provincial Renal Agency, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean J.","family":"Barbour","sequence":"additional","affiliation":[{"name":"BC Provincial Renal Agency, Vancouver, Canada"},{"name":"Division of Nephrology, The University of British Columbia, Vancouver, Canada"},{"name":"Centre for Health Evaluation and Outcome Sciences, St. Paul\u2019s Hospital, Vancouver, BC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,19]]},"reference":[{"key":"bibr1-20543581221090010","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2017090958"},{"key":"bibr2-20543581221090010","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1692-x"},{"key":"bibr3-20543581221090010","doi-asserted-by":"publisher","DOI":"10.1016\/0272-6386(95)90120-5"},{"key":"bibr4-20543581221090010","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4192578"},{"key":"bibr5-20543581221090010","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00570109"},{"key":"bibr6-20543581221090010","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-009-1376-6"},{"issue":"1","key":"bibr7-20543581221090010","first-page":"27","volume":"12","author":"Hoseini R","year":"2018","journal-title":"Iran J Kidney Dis"},{"key":"bibr8-20543581221090010","doi-asserted-by":"publisher","DOI":"10.1177\/2054358118759551"},{"issue":"2","key":"bibr9-20543581221090010","first-page":"139","volume":"2","author":"Cattran DC","year":"2012","journal-title":"KDIGO Clinical Practice Guideline for Glomerulonephritis. 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