Journal of Biomedicine and Practice – Biomeditsina va amaliyot jurnali 11-jild 2-son (2026)
USING MONOCLONAL ANTIBODIES IN THE TREATMENT OF STEROID-SENSITIVE NEPHROTIC SYNDROME IN CHILDREN
ФАЙЗАХМАТОВ Феруза Озод кизи, ХАМЗАЕВ Комилжон Амирович, МАМАТҚУЛОВ Бахром Бoсимович
Annotatsiya
Introduction. Nephrotic syndrome (NS) is one of the most common glomerular diseases in childhood. Although corticosteroids remain the cornerstone of initial therapy, approximately 50% of affected children develop frequently relapsing or steroid-dependent disease. In cases refractory to conventional immunosuppressive agents, rituximab - a chimeric anti-CD20 monoclonal antibody - has emerged as a promising therapeutic option. Aim. To evaluate the efficacy of rituximab in achieving sustained remission in children with steroid-sensitive nephrotic syndrome and to identify clinical predictors of favourable treatment outcomes. Methods. A prospective study enrolled 85 children with primary NS treated at the National Children's Medical Centre between 2021 and 2025. All patients received two rituximab infusions (750 mg/m²) administered 14 days apart; those maintaining remission received repeated infusions every six months (three courses total). Statistical analysis included the Mann–Whitney U test for continuous variables and Fisher's exact test with odds ratio (OR) calculation for categorical data. Results. Sustained remission was achieved in 68 patients (80%); post-treatment relapse occurred in 33 children (38.8%). Statistically significant predictors of remission included older age at disease onset (5.07 vs 3.49 years; p=0.023), older age at the time of rituximab administration (11.57 vs 8.90 years; p=0.013), and low pre-treatment relapse frequency (p=0.010). Continued immunosuppressive therapy after rituximab was associated with lower odds of remission (OR=0.172; 95% CI: 0.053–0.560; p=0.004), most likely reflecting confounding by indication. Gender, biopsy findings, and disease duration prior to treatment were not significant predictors. No serious adverse events were recorded; mild infusion reactions occurred in 7.1% of patients. Conclusion. Rituximab is a highly effective and well-tolerated treatment for steroid-sensitive nephrotic syndrome in children, achieving sustained remission in 80% of patients with a six-monthly re-dosing protocol. Older age at disease onset, older age at first infusion, and low pre-treatment relapse frequency are associated with favourable outcomes. Prospective studies are needed to optimise dosing regimens and re-treatment intervals.
Нефротический синдром, ритуксимаб, стероид-чувствительный нефротический синдром, деплеция В-лимфоцитов, иммуносупрессия, CD20Nephrotic syndrome, rituximab, steroid-sensitive nephrotic syndrome, B-cell depletion, immunosuppression, CD20Nefrotik sindrom, rituksimab, steroidga sezgir nefrotik sindrom, B-limfotsitlar deplesiyasi, immunosupressiya, CD20
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