{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:43:20Z","timestamp":1791855800054,"version":"4.3.4"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Research background<\/jats:title><jats:p>This study was aimed to retrospectively investigate the efficacy and safety of rituximab (RTX) versus glucocorticoids (GC) as initial treatments for patients with minimal change disease (MCD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Research methods<\/jats:title><jats:p>Patients who were diagnosed with MCD through kidney biopsy and received RTX or GC as the initial treatment regimen were included and matched by propensity score (ratio: 1:1) based on age, sex, urine protein, and eGFR. The 2 groups each consist of 12 adult patients and 2 pediatric patients. We primarily observed the clinical remission rate at 24-week, the time to induction of remission in each group, the time to first relapse-free survival, relapse rate, as well as the changes in the urine protein-to-creatinine ratio and serum albumin levels compared to baseline during the treatment period. The incidence of adverse effects was also observed in 2 groups during the whole period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Research results<\/jats:title><jats:p>All 28 patients (100.00%) achieved clinical remission, with 22 patients (78.57%) achieving complete remission (CR) and 6 patients (21.43%) achieving partial remission (PR) at 24-week. The median time to remission was 5 (3-7) weeks. During the 24-week follow-up, the RTX group and the GC group each had 2 patients with recurrence, resulting in a relapse rate of 14.29%. Both the RTX group and the GC group had 14 patients (100%) achieve clinical remission, with 11 patients (78.57%) reaching CR and 3 patients (21.43%) achieving PR. The median time to remission in the RTX group was 5 (3-7) weeks, while in GC group, it was 5 (3-8) weeks (p=0.728). Follow-up results at 24 weeks indicated that the UPCR levels for all MCD patients decreased from an average of 8.93 (range 6.13-17.48) g\/g to 0.07 (range 0.03-0.28) g\/g, with no statistically significant difference between 2 groups (P=0.945). Serum albumin levels increased from 18.60 \u00b1 7.54 g\/L to 44.39 \u00b1 4.50 g\/L, with no significant intergroup difference (P=0.601). In the RTX group, patients tolerated RTX well, with only 1 case of tachycardia occurring during infusion, which resolved spontaneously after reducing the infusion rate. In the GC group, there were no severe adverse reactions reported. However, 10 patients experienced weight gain, 3 patients exhibited elevated blood glucose levels, 2 patients presented with skin striae, and 1 patient showed elevated transaminases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of RTX can effectively induce and maintain remission in MCD patients, demonstrating efficacy comparable to those treated with GC. Furthermore, the safety profile is favorable, making it a viable alternative to GC therapy. This provides a reliable initial treatment option for patients with MCD, particularly for pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1528996","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T05:26:25Z","timestamp":1745472385000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Observation of rituximab as initial treatment in patients with minimal change disease- a retrospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Sha","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu-Yao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao-Miao","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang-Yi","family":"Lv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Zong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Yan","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Dong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2019.12.019","article-title":"Approach to diagnosis and management of primary glomerular diseases due to podocytopathies in adults: core curriculum 2020","volume":"75","author":"Ahn","year":"2020","journal-title":"Am J Kidney diseases: Off J Natl Kidney Foundation"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.05000516","article-title":"Minimal change disease","volume":"12","author":"Vivarelli","year":"2017","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(03)14184-0","article-title":"Nephrotic syndrome in childhood","volume":"362","author":"Eddy","year":"2003","journal-title":"Lancet (London England)"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.03531006","article-title":"Adult minimal-change disease: clinical characteristics, treatment, and outcomes","volume":"2","author":"Waldman","year":"2007","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.015","article-title":"Executive summary of the kdigo 2021 guideline for the management of glomerular diseases","volume":"100","author":"Rovin","year":"2021","journal-title":"Kidney Int"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.2215\/cjn.06180519","article-title":"Randomized, controlled trial of tacrolimus and prednisolone monotherapy for adults with de novo minimal change disease: A multicenter, randomized, controlled trial","volume":"15","author":"Medjeral-Thomas","year":"2020","journal-title":"Clin J Am Soc Nephrology: CJASN"},{"key":"B7","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/s0163-7258(02)00297-8","article-title":"Mechanisms involved in the side effects of glucocorticoids","volume":"96","author":"Sch\u00e4cke","year":"2002","journal-title":"Pharmacol Ther"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/08923973.2021.1966033","article-title":"Transplantation and immunosuppression: A review of novel transplant-related immunosuppressant drugs","volume":"43","author":"Parlakpinar","year":"2021","journal-title":"Immunopharmacol immunotoxicology"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/01.asn.0000016406.82019.b3","article-title":"T cells and minimal change disease","volume":"13","author":"Cunard","year":"2002","journal-title":"J Am Soc Nephrology: JASN"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2314471","article-title":"Autoantibodies targeting nephrin in podocytopathies","volume":"391","author":"Hengel","year":"2024","journal-title":"New Engl J Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1056\/NEJMoa1814427","article-title":"Rituximab or cyclosporine in the treatment of membranous nephropathy","volume":"381","author":"Fervenza","year":"2019","journal-title":"New Engl J Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102671","article-title":"Rituximab in adult minimal change disease and focal segmental glomerulosclerosis - 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