Anti-rituximab antibodies do not affect rituximab impact in idiopathic nephrotic syndrome
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The presence of anti-rituximab antibodies does not change the response that pediatric patients with steroid-dependent nephrotic syndrome have to rituximab treatment, according to a speaker from ASN Kidney Week.
“As nephrologists, we still do not know the exact clinical impact of antibodies anti-rituximab on rituximab,” Andrea Angeletti, MD, PhD, from the division of nephrology, dialysis and transplantation at IRCCS Gaslini Pediatric Hospital in Italy, said. “So, there is an issue in terms of efficacy and safety of the infusion of rituximab in the development of antibodies.”
Researchers randomized 140 children treated with a single infusion of ofatumumab, including 64 participants who previously received rituximab. Anti-rituximab antibodies were assessed for immunoglobulin G (IgG) at the enrollment of the 64 participants and at the 6-month follow-up of participants randomized to the rituximab arm.
A follow-up occurred at 24 months to determine the efficacy of ofatumumab vs. rituximab in children and young adults with steroid-dependent nephrotic syndrome.
Results revealed ofatumumab was not superior to rituximab in maintaining remission. Although serum anti-rituximab antibodies IgG were undetectable at baseline in the 64 participants who previously received the treatment, the levels increased in 14 of the 33/64 participants who were randomized in the rituximab arm from baseline to the 6-month follow-up.
Of the patients who did relapse in the rituximab arm, the efficacy of a second rituximab infusion was not impacted by the presence of anti-rituximab antibodies.
“In conclusion, I can say that the patients treated with one single infusion of rituximab developed anti-rituximab antibodies,” Angeletti said. “But the presence of these antibodies does not affect the efficacy and safety of further infusions because patients who were anti-rituximab and received more infusions of rituximab did not show any type of infusion-related reactions.”
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Angeletti A, et al. Antibodies anti-rituximab do not affect response to rituximab in idiopathic nephrotic syndrome. Presented at: ASN Kidney Week; Nov. 4-7, 2021 (virtual meeting).
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