Submitted: 11 Feb 2019
Accepted: 26 May 2019
First published online: 06 Jul 2019
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Immunopathol Persa. 2019;5(2):e15-e15.
doi: 10.15171/ipp.2019.15
  Abstract View: 127
  PDF Download: 162

Original

Rituximab versus cyclophosphamide for the treatment of children with steroid resistance nephrotic syndrome; a clinical trial study 

Mohsen Akhavan Sepahi 1,2 ORCiD, Najmeh Farahani 2, Mohammad Reza Razavi 1,2 * ORCiD, Hossein Heydari 2,3 ORCiD, Shahram Arsang-Jang 4 ORCiD

1 Department of Pediatric Nephrology, School of Medicine, Qom University of Medical Sciences, Qom, Iran
2 Pediatric Clinical Research of Development Center, Hazrat Masoomeh Hospital, Qom University of Medical Sciences, Qom, Iran
3 Department of Pediatric Infectious disease, School of Medicine, Qom University of Medical Sciences, Qom, Iran
4 Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran
*Correspondence to Mohammad Reza Razavi, Email: Email: Dr.rezarazavimd@Gmail.com

Abstract

Introduction: The most common complications of the nephrotic syndrome (NS) are the frequent relapses, steroid resistance, and long-term steroid administration.

Objectives: This study aimed to compare the therapeutic effect of rituximab versus cyclophosphamide in the prevention of relapses and the complications of treatment in children with steroid-resistant NS.

Patients and Methods: This clinical trial study was performed on 50 patients with resistant steroidal NS referred to Masoumeh hospital in Qom, Iran. Patients were randomly divided into the two groups including intervention (n=20) and control groups (n=30). In addition to the prednisolone, the intervention group received 375 mg/m2/weekly rituximab intravenously for 4 weeks. The control group received oral doses of cyclophosphamide 2 mg/kg/d for 3 months. During treatment, the frequency of relapses, the mean dose of steroid and the complications of treatment were compared with a paired t-test, independent t-test, and chi-square test.

Results: A significant decrease in the mean dose of steroids and the mean number of relapses were seen in patients after administration of rituximab and cyclophosphamide (P<0.001). However, rituximab reduced the dose of steroid administration by 12.25 mg/d, while cyclophosphamide reduced only 2.83 mg/d (P<0.001). Rituximab reduced the relapse rate two times on average, while cyclophosphamide reduced only 0.5 times (P<0.001). The incidence of complications in the cyclophosphamide group was found to be more severe than the rituximab group.

Conclusion: To compare rituximab versus cyclophosphamide regarding lower the frequency of recurrence after treatment, we found rituximab is a more suitable drug for the treatment of steroid-resistant NS than cyclophosphamide.

Citation: Akhavan Sepahi M, Farahani N, Razavi MR, Heydari H, ArsangJang S. Rituximab versus cyclophosphamide for the treatment of children with steroid resistance nephrotic syndrome; a clinical trial study. Immunopathol Persa. 2019;5(2):e15. DOI:10.15171/ ipp.2019.15.
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