{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:08:44Z","timestamp":1740146924690,"version":"3.37.3"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T00:00:00Z","timestamp":1711670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["20FC1045"],"award-info":[{"award-number":["20FC1045"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In Japan, rituximab (RTX) for adult-onset frequently relapsing (FR)\/steroid-dependent (SD) minimal change disease (MCD) is not explicitly reimbursed by insurance, and its standard regimen has not been established.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a cross-sectional web-based survey between November and December 2021. The participants were nephrologists certified by the Japanese Society of Nephrology and answered 7 items about RTX for adult MCD. Factors related to the experience of RTX administration at their facilities were estimated by generalized estimating equations.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 380 respondents, 181 (47.6%) reported the experience of RTX use for adult MCD at their current facilities. Those who worked at university hospitals (vs. non-university hospitals, proportion difference 13.7%) and at facilities with frequent kidney biopsies (vs. 0 cases\/year, 19.2% for 1\u201340 cases\/year; 37.9% for 41\u201380 cases\/year; 51.9% for \u2265 81 cases\/year) used RTX more frequently. Of 181 respondents, 28 (15.5%) answered that there was no insurance coverage for RTX treatment. Of 327 respondents who had the opportunity to treat MCD, which was a possible indication for RTX, 178 (54.4%) indicated withholding of RTX administration. The most common reason was the cost due to lack of insurance coverage (141, 79.2%). Regarding RTX regimens for FR\/SD MCD, introduction treatment with a single body surface area-based dose of 375 mg\/m<jats:sup>2<\/jats:sup> and maintenance treatment with a 6-month interval were the most common.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This survey revealed the nephrologists\u2019 characteristics associated with RTX use, the barriers to RTX use, and the variation in the regimens for adult MCD in Japan.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299053","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T17:28:56Z","timestamp":1711733336000},"page":"e0299053","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Japanese clinical practice patterns of rituximab treatment for minimal change disease in adults 2021: A web-based questionnaire survey of certified nephrologists"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5830-5785","authenticated-orcid":true,"given":"Masahiro","family":"Koizumi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuji","family":"Ishimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9283-144X","authenticated-orcid":true,"given":"Sayaka","family":"Shimizu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-5931","authenticated-orcid":true,"given":"Sho","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4127-7500","authenticated-orcid":true,"given":"Noriaki","family":"Kurita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiko","family":"Wada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,3,29]]},"reference":[{"issue":"2","key":"pone.0299053.ref001","doi-asserted-by":"crossref","first-page":"332","DOI":"10.2215\/CJN.05000516","article-title":"Minimal Change Disease","volume":"12","author":"M Vivarelli","year":"2017","journal-title":"Clin J Am Soc Nephrol"},{"issue":"9950","key":"pone.0299053.ref002","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/S0140-6736(14)60541-9","article-title":"Rituximab for childhood-onset, complicated, frequently relapsing nephrotic syndrome or steroid-dependent nephrotic syndrome: a multicentre, double-blind, randomised, placebo-controlled trial","volume":"384","author":"K Iijima","year":"2014","journal-title":"Lancet"},{"issue":"4S","key":"pone.0299053.ref003","first-page":"S1","article-title":"KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases","volume":"100","author":"Kidney Disease: Improving Global Outcomes Glomerular Diseases Work G","year":"2021","journal-title":"Kidney Int"},{"journal-title":"Evidence-based clinical practice guidelines for nephrotic syndrome 2020: Tokyo Igakusha","year":"2020","author":"OH Narita I","key":"pone.0299053.ref004"},{"issue":"12","key":"pone.0299053.ref005","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s10157-021-02098-5","article-title":"A digest of the Evidence-Based Clinical Practice Guideline for Nephrotic Syndrome 2020","volume":"25","author":"T Wada","year":"2021","journal-title":"Clin Exp Nephrol"},{"issue":"4","key":"pone.0299053.ref006","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1093\/ckj\/sfaa191","article-title":"Efficacy and safety of rituximab in adult frequent-relapsing or steroid-dependent minimal change disease or focal segmental glomerulosclerosis: a systematic review and meta-analysis","volume":"14","author":"C Xue","year":"2021","journal-title":"Clin Kidney J"},{"key":"pone.0299053.ref007","article-title":"Japanese clinical practice patterns of primary nephrotic syndrome 2021: a web-based questionnaire survey of certified nephrologists","author":"T Wada","year":"2023","journal-title":"Clin Exp Nephrol"},{"issue":"6","key":"pone.0299053.ref008","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1093\/jjco\/hyac034","article-title":"Overview of the ethical guidelines for medical and biological research involving human subjects in Japan","volume":"52","author":"J Eba","year":"2022","journal-title":"Jpn J Clin Oncol"},{"key":"pone.0299053.ref009","unstructured":"Japanese Medical Specialty Board. List of the numbers of members and certified physicians of each society (as of August 2021) (In Japanese) 2022 [cited 2023 19 Dec]. Available from: https:\/\/jmsb.or.jp\/wp-content\/uploads\/2022\/04\/gaiho_2021.pdf."},{"key":"pone.0299053.ref010","unstructured":"Ministry of Health, Labour and Welfare. Summary of Static\/Dynamic Survey of Medical Institutions and Hospital Report, 2020 (in Japanese) 2022 [cited 2023 19 Dec]. Available from: https:\/\/www.mhlw.go.jp\/toukei\/saikin\/hw\/iryosd\/20\/dl\/09gaikyo02.pdf."},{"key":"pone.0299053.ref011","unstructured":"Japanese Society of Nephrology. Teaching facilities accredited by the Japanese Society of Nephrology (715 facilities as of July 18, 2023) (In Japanese) 2023 [cited 2023 19 Dec]. Available from: https:\/\/jsn.or.jp\/jsninfo\/about\/facilities\/."},{"issue":"6","key":"pone.0299053.ref012","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1093\/aje\/kwaa044","article-title":"Estimating Risk Ratios and Risk Differences Using Regression","volume":"189","author":"AI Naimi","year":"2020","journal-title":"Am J Epidemiol"},{"key":"pone.0299053.ref013","first-page":"218","article-title":"Exploring Patient Path Through Sankey Diagram: A Proof of Concept","volume":"270","author":"A Lamer","year":"2020","journal-title":"Stud Health Technol Inform"},{"key":"pone.0299053.ref014","doi-asserted-by":"crossref","first-page":"46036","DOI":"10.1038\/srep46036","article-title":"Cost-Effectiveness of Administering Rituximab for Steroid-Dependent Nephrotic Syndrome and Frequently Relapsing Nephrotic Syndrome: A Preliminary Study in Japan","volume":"7","author":"T Takura","year":"2017","journal-title":"Sci 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Transplant"},{"issue":"42","key":"pone.0299053.ref021","doi-asserted-by":"crossref","first-page":"e12704","DOI":"10.1097\/MD.0000000000012704","article-title":"Comparison of the response of frequently relapsing steroid-dependent minimal change nephrotic syndrome to rituximab therapy between childhood-onset and adult-onset disease","volume":"97","author":"Y Iwabuchi","year":"2018","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"pone.0299053.ref022","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5414\/CN110245","article-title":"Retrospective single-arm cohort study of steroid-dependent minimal change nephrotic syndrome treated with very low-dose rituximab","volume":"95","author":"K Fujimoto","year":"2021","journal-title":"Clin Nephrol"},{"issue":"1","key":"pone.0299053.ref023","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12882-023-03092-7","article-title":"Efficacy of low-dose rituximab in minimal change disease and prevention of relapse","volume":"24","author":"J Zhang","year":"2023","journal-title":"BMC Nephrol"},{"issue":"1","key":"pone.0299053.ref024","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s10157-015-1139-6","article-title":"Amelioration of the adverse effects of prednisolone by rituximab treatment in adults with steroid-dependent minimal-change nephrotic syndrome","volume":"20","author":"Y Miyabe","year":"2016","journal-title":"Clin Exp Nephrol"},{"issue":"4","key":"pone.0299053.ref025","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1093\/ndt\/gfac228","article-title":"Sequential rituximab therapy sustains remission of nephrotic syndrome but carries high risk of adverse effects","volume":"38","author":"A Sinha","year":"2023","journal-title":"Nephrol Dial Transplant"},{"issue":"2","key":"pone.0299053.ref026","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1681\/ASN.2021050643","article-title":"Mycophenolate Mofetil after Rituximab for Childhood-Onset Complicated 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IDEC-C2B8 clinical phase III trial (A-TEAM study): Japan Registry of Clinical Trials; 2020 [cited 2023 13 Aug]. 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