Use of rituximab in paediatric nephrology

Arch Dis Child. 2021 Nov;106(11):1058-1065. doi: 10.1136/archdischild-2020-321211. Epub 2021 Jun 10.

Abstract

Rituximab is a chimeric monoclonal antibody capable of depleting B cell populations by targeting the CD20 antigen expressed on the cell surface. Its use in oncology, initially in B cell lymphoma and post-transplant lymphoproliferative disorders, predates its current utility in various fields of medicine wherein it has become one of the safest and most effective antibody-based therapies. It was subsequently found to be effective for rheumatological conditions such as rheumatoid arthritis and antineutrophil cytoplasmic antibody-associated vasculitis. Over the past decade, rituximab has generated a lot of interest in nephrology and has become an emerging or accepted therapy for multiple renal conditions, including systemic lupus erythematosus, lupus nephritis, vasculitis, nephrotic syndrome and in different scenarios before and after kidney transplantation. This review outlines its current use in paediatric nephrology practice, focusing on the knowledge required for general paediatricians who may be caring for children prescribed this medication and reviewing them on a shared care basis.

Keywords: nephrology; therapeutics.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Intravenous
  • Antibodies, Monoclonal / therapeutic use
  • Antigens, CD20 / drug effects*
  • B-Lymphocytes / drug effects
  • B-Lymphocytes / immunology
  • Child
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / pharmacokinetics*
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use
  • Kidney Diseases / drug therapy
  • Kidney Diseases / immunology
  • Kidney Transplantation / adverse effects
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Nephritis / drug therapy
  • Lupus Nephritis / immunology
  • Nephrology / standards*
  • Nephrology / statistics & numerical data
  • Nephrotic Syndrome / drug therapy
  • Pediatricians / statistics & numerical data
  • Practice Guidelines as Topic
  • Rituximab / administration & dosage
  • Rituximab / pharmacokinetics*
  • Rituximab / pharmacology
  • Rituximab / therapeutic use
  • Vasculitis / drug therapy

Substances

  • Antibodies, Monoclonal
  • Antigens, CD20
  • Immunologic Factors
  • Rituximab