Table 1 Characteristics of included studies
Study | Year | Country | Type of Study | Patients | Number | Intervention | Mean RTX Dose mg/m2 (median ± IQR) | Outcomes | CD19/20 Depletion rate | Study Follow-up Time | Serious Adverse Events |
|---|---|---|---|---|---|---|---|---|---|---|---|
Fernandez-Fresnedo et al. [14] | 2009 | Spain | Observational (prospective) | SR FSGS | 8 | RTX | 1500 | SCr: 1.4 ± 0.5 (pre) vs. 2.2 ± 1.8 (post) Proteinuria: 14.0 ± 4.4 (pre) vs. 10.5 ± 4.9 (post) Remission: 0% (CR 0%, PR 0%) | CD20 depleted 100% | 16.4 ± 5.1 mo | None |
Hoxha et al. [15] | 2011 | Germany | Observational (prospective) | FR and SD MCD | 6 | RTX | 375 | CR: 5/6 (83.3%) PR: 1/6 (16.7%) Relapse (17.2 ± 4.8 mo): 3/6 (50%) – all were successfully treated with rituximab | B-cell depleted 100% | 17.2 ± 4.8 mo | None |
Sugiura et al. [16] | 2011 | Japan | Observational (prospective) | SD MCD and FSGS | 14 (10, MCD; 4, FSGS) | RTX | 375 | MCD – Proteinuria*: 3.8 ± 4.1 (pre) vs. 0.42 ± 1.2 (post) MCD - SCr: 0.7 ± 0.2 (pre) vs. 0.7 ± 0.2 (post) FSGS – Proteinuria*: 5.2 ± 2.4 (pre) vs. 2.3 ± 2.8 (post) FSGS - SCr: 1.1 ± 0.6 (pre) vs. 1.0 ± 0.5 (post) Follow-up time 6 months | B-cell depleted 100% | 6 mo | Cutaneous eruption (7.1%) |
Kong et al. [17] | 2013 | Australia | Observational (retrospective) | MCD and FSGS with other current treatment | 11 (7, MCD; 4, FSGS) | RTX | 600 ± 900 mg total [FSGS 600 ± 725; MCD 600 ± 1500)] | Complete remission: total 7/11 (63.6%), MCD 5/7 (71.4%), FSGS 2/4 (50%) Partial remission: total 3/11 (27.2%), MCD 2/7 (28.6%), FSGS ¼ (25%) No response: 1/11 (9.1%) Relapse: total 3/11 (27.2%), MCD 2/7 (28.6%), FSGS 0% | N/A | 26.5 ± 16 mo [19 mo (13–43) for MCD and 29 mo (11.8–49.3) for FSGS] | Infusion reaction (33.3%) Pneumonia (4.2%) |
Munyentwali et al. [18] | 2013 | France | Observational (prospective) | FR or SD MCD | 17 | RTX | 1125 ± 750 | Remission: 11/17 (64.7%) Relapse: 6/17 (35.3%), only 4/6 (66.7%) of relapsed patients achieved remission at last follow-up Mean follow-up: 29.5 ± 18.2 months | N/A | 29.5 mo (5.1–82) | None |
Takei et al. [19] | 2013 | Japan | Observational (prospective) | SD MCNS | 25 | RTX | 375 | Remission: 22/25 (88%) Relapse: 3/25 (12%) Follow-up time 12 months | B-cell depleted 100% | 12 mo | Fixed drug eruption (4%) Leukopenia (4%) |
Bruchfeld et al. [20] | 2014 | Sweden | Observational (prospective) | GC-dependent or GC-resistant MCD | 16 | RTX | 1250 ± 1300 (median ± IQR) | Complete remission: 13/16 (81.3%) Partial remission: 2/16 (12.5%) Relapse at 28 months: 7/16 (43.8%) | B-cell depleted 100% | 44 ± 43 mo | None |
Guitard et al. [21] | 2014 | France | Observational (retrospective) | MCNS with other concomitant treatment | 41 | RTX + conventional treatment | 2000 ± 500 (median ± IQR) | Complete remission: 25/41 (61.0%) Partial remission: 7/41 (17.1%) Relapse at median time of 18 months: 18/32 (56.2%) | B-cell depleted 100% | 44 (6–82) mo | None |
Ruggenenti et al. [22] | 2014 | Italy | Observational (prospective) | FR or SD FSGS in remission | 8 | RTX | 375 | Remission: 8/8 (100%) as all patients were in remission at initial Relapse: 3/8 (37.5%) Follow-up time: 12 months | B-cell depleted 100% | 12 mo | None |
Papakrivopoulou et al. [23] | 2016 | UK | Observational (prospective) | FR or SD MCD | 15 | RTX | 2000 ± 1000 (median ± IQR) | Remission: 10/15 (66.7%) Relapse: 5/15 (33.3%) Median steroid free survival after RTX was 25 months (range 4–34) Mean relapse frequency decreased from 2.60 ± 0.28 to 0.4 ± 0.19 * | B-cell depleted 100% | 20 ± 14 mo | Type 1 hypersensitivity (46%) |
King et al. [24] | 2017 | UK | Observational (retrospective) | FR MCD | 13 | RTX | 2000 mg total | Remission: 6/13 (46.2%) Relapse at 20 mo: 7/13 (53.8%). All patients were in remission following subsequent rituximab Median number of relapses was reduced from 4 to 0.4 episodes/year | N/A | 20 mo (6–85) | None |
Ren et al. [25] | 2017 | China | Observational (prospective) | SD or SR MCD or FSGS | 15 (9, MCD; 6, FSGS) | RTX | 1500 | Complete remission: 13/15 (86.7%) Partial remission: 2/15 (13.3%) Relapse at 10 months: 2/15 (13.3%) All relapsed cases achieved CR by month 12 | B-cell depleted 100% | 8 mo (3–36) | None |
Roccatello et al. [26] | 2017 | Italy | Observational (prospective) | Treatment-naïve FSGS | 8 | RTX | 3000 | Proteinuria: mean 5.1 ± 1.9 g/24 h (pre) vs. 3.8 ± 1.8 (post) SCr: mean 2.4 ± 1.2 mg/dL (pre) vs. 3.2 ± 2.5 (post) PR: 1/8 (12.5%) CR: 0/8 (0%) Follow-up time 18 months | N/A | 29.1 ± 8.8 mo | None |
Cortazar et al. [27] | 2018 | USA | Observation (prospective) | FR, SD or SR MCD and FSGS | 20 (13, MCD; 7, FSGS) | RTX for continuous B-cell depletion | 3375 ± 750 mg total (MCD 3375 ± 1687.5; FSGS 3000 ± 1875) | Complete remission: 11/13 (84.6%, MCD) and 1/7 (14.3%, FSGS) Partial remission: 2/13 (15.4%, MCD) and 6/7 (85.7%, FSGS) Relapse at 3 years: None for MCD and 4/7 (57.1%, FSGS) | B-cell depleted 100% | 35 mo (range 19, 57; IQR 33.75) MCD, 39 ± 26 mo FSGS, 29 ± 56 mo | Serious infection 0.04 infections per year (95% CI 0.012–0.12) Serious adverse events 0.10 events per year (95% CI 0.04–0.21) |
Fenoglio et al. [28] | 2018 | Italy | Observational (retrospective) | Treatment naïve MCD | 6 | RTX | 1500 | SCr: 1.95 ± 1.80 (pre) vs. 0.82 ± 0.22 (post) Proteinuria*: 11.75 ± 8.50 (pre) vs. 0.28 ± 0.50 (post) CR: 5/6 (83.3%) PR: 1/6 (16.7%) | B-cell depleted 100% | 21.5 mo (8–36) | None |
Ramachandran et al. [29] | 2019 | India | Observational (prospective) | CNI-dependent MCD/FSGS | 24 (11, MCD; 13, FSGS) | RTX for persistent B-cell depletion | 791.66 ± 131.60 mg total (range 600–1100) | Remission at 12 mo was 79.16% (CR 62.5%, PR 25%) and at last visit (mean 30.58 ± 9.24 mo) was 83.3% MCD: CR 100% at 12 mo; 3/11 (27.3%) relapsed FSGS: CR 53.84% (7/13) and PR 15.38% (2/13) at last visit. Relapse rate 5/6 (83.3%) | B-cell depleted 100% | 30.58 ± 9.24 mo | None |