Progress in clinical application of anti-CD20 monoclonal antibody in refractory nephrotic syndrome in children
- VernacularTitle:抗CD20单抗在儿童难治性肾病综合征中的临床应用进展
- Author:
Jinbo XIANG
1
;
Guanguo SHEN
2
;
Zheng LI
1
;
Xiaoyan HU
1
;
Tingting CAO
1
;
Ziran XU
1
;
Ting DING
1
;
Jingbo LI
1
Author Information
1. Dept. of Pediatrics，Affiliated Renhe Hospital of China Three Gorges University，Hubei Yichang 443001，China
2. Dept. of Pediatrics，Yiling Hospital of Yichang City，Hubei Yichang 443001，China
- Publication Type:Journal Article
- Keywords:
refractory nephrotic syndrome;
children;
anti-CD20 monoclonal antibody;
rituximab;
ofatumumab;
obinutuzumab
- From:
China Pharmacy
2025;36(16):2078-2084
- CountryChina
- Language:Chinese
-
Abstract:
Anti-CD20 monoclonal antibodies for the treatment of refractory nephrotic syndrome （RNS） in children. The first- generation rituximab is the most widely used in clinical practice； it shows definite efficacy in children with RNS， is recommended by guidelines， particularly for achieving a high remission rate in minimal change nephrosis， and can significantly reduce the cumulative use of glucocorticoids and immunosuppressants. The second-generation ofatumumab has potential as an alternative treatment for patients who are intolerant or resistant to rituximab， while the third-generation obinutuzumab has shown efficacy in complex cases such as rituximab resistance or post-transplant recurrence. However， there is still controversy regarding the optimization of rituximab treatment dosage and whether ofatumumab and obinutuzumab offer greater advantages than rituximab for the treatment of RNS in children. The most common adverse reaction induced by anti-CD20 monoclonal antibodies is infusion reactions， and long-term adverse events mainly include increased risks of sustained immunosuppression and infections. Rituximab has significant economic advantages for the treatment of RNS， but additional pharmacoeconomic research based on China’s healthcare environment is needed to evaluate the cost-effectiveness of ofatumumab and obinutuzumab in this population. Given that the current use of ofatumumab and obinutuzumab in this field is considered off-label use， clinical application should only proceed after a rigorous evaluation of the patient’s benefits and risks.
