Combined Rituximab and Daratumumab Treatment in Difficult-to-Treat Nephrotic Syndrome Cases
Andrea Angeletti, Sofia Bin, Xhuliana Kajana, Sonia Spinelli, Carolina Bigatti, Gianluca Caridi, Giovanni Candiano, Francesca Lugani, Enrico Verrina, Edoardo La Porta, Alberto Magnasco, Maurizio Bruschi, Paolo Cravedi, Gian Marco Ghiggeri
Abstract
Idiopathic nephrotic syndrome (NS) is characterized by severe proteinuria, hypoalbuminemia, and/or edema and affects about 1 to 3 per 100,000 children and young adults.1 Corticosteroids represent the first line therapy for primary NS, leading to disease remission in 70% to 80% of cases.2 However, 70% to 80% may relapse after steroid withdrawal, and approximately 10% to 30% of patients have steroid-resistant NS. Treatment of steroid-resistant NS includes calcineurin inhibitors, mycophenolate mofetil, and anti-CD20 monoclonal antibodies (rituximab or obinutuzumab) used alone or in combination.