Long-term Efficacy and Safety of Rituximab Combined with Calcineurin Inhibitors in the Treatment of Refractory Nephrotic Syndrome
10.13241/j.cnki.pmb.2025.12.004
- VernacularTitle:利妥昔单抗联合钙调磷酸酶抑制剂治疗难治性肾病综合征的远期疗效与安全性
- Author:
Hao ZHANG
1
;
Zheng-chuan PU
1
;
Dan LIU
1
;
Ji ZHOU
1
;
Qian YANG
1
Author Information
1. 中国人民武装警察部队四川省总队医院肾脏内科 四川乐山 614000
- Publication Type:Journal Article
- Keywords:
Rituximab;
Calcineurin inhibitor;
Refractory nephrotic syndrome;
Long term efficacy;
Security
- From:
Progress in Modern Biomedicine
2025;25(12):1948-1954
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to evaluate the long-term efficacy and safety of rituximab(RTX)combined with calcineurin inhibitors(CNI)in the treatment of refractory nephrotic syndrome(RNS).Methods:A total of 80 patients with steroid-dependent/resistant RNS were prospectively enrolled and randomly assigned to an observation group(RTX+CNI,n=40)and a control group(CNI monotherapy,n=40).Patients were followed up for 24 months.Dynamic comparisons were made between the two groups regarding complete remission rate,relapse rate,24-hour urinary protein,kidney injury molecule-1(KIM-1),and adverse reactions.Results:The complete remission rate(CR)in the observation group was significantly higher than that in the control group at all time points(24-month CR:100％vs 90％,P＜0.05).The 24-month relapse rate was significantly lower in the observation group compared to the control group(0％vs 10％,P＜0.05).Combination therapy significantly reduced 24-hour urinary protein levels(6 months:2.13±0.63 vs 3.86±1.01 g/24 h,P＜0.001)and the renal injury marker KIM-1(6 months:1.53±0.41 vs 2.23±0.65 ng/mL,P＜0.001),and increased the CD4+/CD8+ ratio(24 months:2.03±0.52 vs 1.72±0.41,P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(15％vs 20％,P=0.556).Conclusion:RTX combined with CNI significantly improves the long-term remission rate and reduces the risk of relapse in RNS.Its dual immunomodulatory and multi-target renal protective effects provide evidence-based support for optimizing the treatment of refractory nephrotic syndrome.
