{"title":"Emerging role of Rituximab in adult minimal change disease: a narrative review of clinical evidence, biomarkers and future perspectives.","authors":"Anni Zhong, Yi Yu, Tao Cao, Qijun Wan, Ricong Xu","doi":"10.1186/s12882-025-04086-3","DOIUrl":null,"url":null,"abstract":"<p><p>Minimal change disease (MCD) represents a significant cause of nephrotic syndrome in adults, traditionally managed with corticosteroids despite substantial relapse rates. This review critically evaluates the emerging role of rituximab (RTX) in adult MCD management, synthesizing current evidence across multiple clinical scenarios. Recent studies demonstrate RTX's multifaceted efficacy, particularly in new-onset cases and steroid-dependent/frequently relapsing patients, with the discovery of anti-nephrin antibodies providing unprecedented insights into MCD pathogenesis. RTX's therapeutic mechanisms involve anti-nephrin antibody depletion, T-cell subset modulation, and direct podocyte protection, showing encouraging complete remission rates and substantially reduced relapse rates. While RTX offers a more favorable safety profile compared to long-term corticosteroid therapy, current evidence remains predominantly based on retrospective studies with limited sample sizes. Critical research priorities include large-scale prospective trials, standardization of treatment protocols, and further investigation of anti-nephrin antibodies as therapeutic targets. This review provides evidence-based insights for clinical decision-making while highlighting crucial areas for future investigation in RTX-based MCD management.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"152"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938555/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12882-025-04086-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Minimal change disease (MCD) represents a significant cause of nephrotic syndrome in adults, traditionally managed with corticosteroids despite substantial relapse rates. This review critically evaluates the emerging role of rituximab (RTX) in adult MCD management, synthesizing current evidence across multiple clinical scenarios. Recent studies demonstrate RTX's multifaceted efficacy, particularly in new-onset cases and steroid-dependent/frequently relapsing patients, with the discovery of anti-nephrin antibodies providing unprecedented insights into MCD pathogenesis. RTX's therapeutic mechanisms involve anti-nephrin antibody depletion, T-cell subset modulation, and direct podocyte protection, showing encouraging complete remission rates and substantially reduced relapse rates. While RTX offers a more favorable safety profile compared to long-term corticosteroid therapy, current evidence remains predominantly based on retrospective studies with limited sample sizes. Critical research priorities include large-scale prospective trials, standardization of treatment protocols, and further investigation of anti-nephrin antibodies as therapeutic targets. This review provides evidence-based insights for clinical decision-making while highlighting crucial areas for future investigation in RTX-based MCD management.
期刊介绍:
BMC Nephrology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of kidney and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.