Impact of rituximab on anthropometric indices among childhood steroid-dependent nephrotic syndromes

Arch Dis Child. 2021 Mar;106(3):283-285. doi: 10.1136/archdischild-2019-318019. Epub 2020 Feb 21.

Abstract

Background: There is scarcity of data on impact of rituximab on anthropometrical parameters (weight, height and body mass index i.e. BMI SD score (SDS)) among children with steroid-dependent nephrotic syndromes (SDNS).

Methods: Multicentre retrospective review.

Results: 102 children with SDNS (male: 63%; n=64), median age 7 (IQR: 4.3-9.6) years, received a total of 217 rituximab infusions (total 110 cycles). At median follow-up of 2.1 (IQR: 1.3-2.8) years, 58 (57%) children were off steroids and a significant fall in steroid threshold for relapse was noted (median 0.6; IQR 0.4-0.9 to median 0.3; IQR 0.12 - 0.5 mg/kg/alternate day, p=0.005). Anthropometric parameters (BMI SDS: 0.92±1.8 to 0.25±1.47, p=0.003; weight SDS: 0.20±1.6 to -0.11±1.3, p=0.01; and height SDS: -0.93±1.88 to -0.45±1.54, p=0.04) as well as obesity (38% to 20%, p=0.003) and short stature (11% to 3%, p=0.02) improved. Results remained significant even when analysis was restricted to children ≤12 years (n=88), (BMI SDS: 0.97±1.98 to 0.25±1.5, p=0.001; weight SDS: 0.33±1.6 to 0.02±1.2, p=0.01; and height SDS: -0.67±1.84 to -0.186±1.42, p=0.001).

Conclusions: Use of rituximab resulted in significant steroid sparing effect with an improvement in both growth and obesity parameters.

Keywords: nephrology; therapeutics.

Publication types

  • Multicenter Study

MeSH terms

  • Anthropometry
  • Body Height / drug effects
  • Body Mass Index
  • Body Weight / drug effects
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Growth Disorders / chemically induced*
  • Growth Disorders / epidemiology
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / pharmacology*
  • Infusions, Intravenous
  • Male
  • Nephrotic Syndrome / drug therapy*
  • Nephrotic Syndrome / physiopathology
  • Obesity / chemically induced
  • Obesity / epidemiology
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Rituximab / pharmacology*
  • Steroids / adverse effects*
  • Steroids / therapeutic use

Substances

  • Immunologic Factors
  • Steroids
  • Rituximab