{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:23:50Z","timestamp":1793701430817,"version":"4.5.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Fifty-five percent of patients achieve long-term remission after rituximab treatment. This is influenced by maintenance therapy with rituximab.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>A substantial reduction of annualized relapse rate and concomitant immunosuppression was observed after rituximab treatment.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term outcomes of rituximab-treated adult patients with podocytopathies (either minimal change disease or FSGS) are largely unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study at 30 nephrology departments from 15 countries worldwide included rituximab-treated adults with primary podocytopathies and a minimum clinical follow-up of 36 months. The primary outcome was relapse-free survival at 36 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One hundred eighty-three adult patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =64 with FSGS and\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      =119 with minimal change disease) with difficult-to-treat nephrotic syndrome (68% steroid-dependent\/frequently relapsing, 22% steroid-resistant, 85% previously treated with two or more lines of immunosuppressive therapy) were treated with rituximab as part of a remission induction regimen. Complete or partial remission at 6 months after rituximab treatment was achieved in 82%. Eighty-three of 151 (55%) initial responders achieved long-term relapse-free survival over 3 years. Maintenance therapy with rituximab was associated with a better relapse-free survival (hazard ratio, 2.05; 95% confidence interval [CI], 1.07 to 3.91), irrespective of the dosing regimen. At 36 months, 61% of initial responders receiving maintenance therapy with rituximab achieved long-term relapse-free survival and withdrawal of all concomitant immunosuppressive medication compared with 36% of patients without maintenance treatment (odds ratio, 2.69; 95% CI, 1.27 to 5.73). Relapses per year were reduced from an annual relapse rate of 1.0 (95% CI, 1.0 to 1.7) before to 0.17 (95% CI, 0.00 to 0.24) relapses per year after rituximab initiation. Over the 36 months of follow-up, a stable course of eGFR was observed in those who initially responded with either complete or partial remission, whereas nonresponders experienced a reduction in eGFR reaching \u221211 (95% CI, \u221218 to \u22128) ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rituximab facilitated achievement of initial and long-term response in a majority of adult patients with difficult-to-treat podocytopathies. Maintenance treatment with rituximab was further associated with long-term relapse-free survival over 3 years. Nonresponse to initial rituximab treatment was associated with poor kidney prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.0000000520","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T12:20:02Z","timestamp":1729081202000},"page":"668-678","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":35,"title":["Long-Term Outcomes of Rituximab-Treated Adult Patients with Podocytopathies"],"prefix":"10.1681","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5964-0307","authenticated-orcid":false,"given":"Philipp","family":"Gauckler","sequence":"first","affiliation":[{"name":"Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5099-6713","authenticated-orcid":false,"given":"Anna","family":"Matyjek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria"},{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland"},{"name":"Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine \u2013 National Research Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9082-6302","authenticated-orcid":false,"given":"Seleni","family":"Kapsia","sequence":"additional","affiliation":[{"name":"Clinic of Nephrology and Renal Transplantation, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smaragdi","family":"Marinaki","sequence":"additional","affiliation":[{"name":"Clinic of Nephrology and Renal Transplantation, Laiko General Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7582-8476","authenticated-orcid":false,"given":"Luis F.","family":"Quintana","sequence":"additional","affiliation":[{"name":"Complex Glomerular Disease Unit (CSUR), Nephrology and Renal Transplant Department Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5172-3370","authenticated-orcid":false,"given":"Montserrat M.","family":"Diaz","sequence":"additional","affiliation":[{"name":"Nephrology Department, Fundaci\u00f3n Puigvert, Aut\u00f3noma de Barcelona University, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8918-0404","authenticated-orcid":false,"given":"Catherine","family":"King","sequence":"additional","affiliation":[{"name":"Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5860-9036","authenticated-orcid":false,"given":"Si\u00e2n","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Nephrology, University Hospital of Wales, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1273-9107","authenticated-orcid":false,"given":"Raja","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 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