Comparison of rituximab, cyclophosphamide, and tacrolimus as first steroid-sparing agents for complicated relapsing/steroid-dependent nephrotic syndrome in children: an evaluation of the health-related quality of life

• Published in: Archives of medical science Vol. 18; no. 1; pp. 275 - 278
• Main Authors: Wang, Li, Zhu, Jialiang, Xia, Mingyun, Hua, Ran, Deng, Fang
• Format: Journal Article
• Language: English
• Published: Poland Termedia Publishing House 01-01-2022
• Subjects: cyclophosphamide; frequently relapsing/steroid-dependent nephrotic syndrome; quality of life; Research Letter; rituximab; tacrolimus; cyclophosphamide; quality of life; tacrolimus; frequently relapsing/steroid-dependent nephrotic syndrome; rituximab
• ISSN: 1734-1922; 1896-9151
• DOI: 10.5114/aoms/145587

Frequently-relapsing/steroid-dependent nephrotic syndrome (FRSDNS) leads to steroid toxicity impairing quality of life (QOL), thus prompting the use of steroid-sparing drugs.
51 FRSDNS children not previously treated with steroid-sparing agents were randomized to receive rituximab, cyclophosphamide, or tacrolimus. Clinical findings and QOL were evaluated before and after treatment.
The mean relapse rate in all groups declined six months after treatment, however, 1-year relapse-free survival rate, number of relapses, and cumulative prednisolone dosage were lower with rituximab than with tacrolimus and cyclophosphamide. Cyclophosphamide group had twice frequency of infections compared to the other groups. At 1 year after treatment, total scores showed greater improvement with rituximab.
As first-line steroid-sparing agent, rituximab is more effective and safer than cyclophosphamide and tacrolimus in FRSDNS, and improve QOL.