scholarly journals Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Yewei Chen ◽  
Qian Shen ◽  
Min Dong ◽  
Ye Xiong ◽  
Hong Xu ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Pediatric Patients ◽  
Volume Of Distribution ◽  
Therapeutic Effects ◽  
Dosing Regimen ◽  
Open Label ◽  
Steroid Dependent ◽  
Central Volume ◽  
Higher Doses ◽  
Steroid Dependent Nephrotic Syndrome

Objectives: Rituximab is frequently used off-label for the treatment of frequent-relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS), but the relapse rate remained high and the dosing regimen varied widely. The objective of this study was to characterize rituximab pharmacokinetics (PK) in pediatric patients with FRNS/SDNS, and to investigate the differences in rituximab PK between patients with FRNS/SDNS and other disease populations.Methods: Fourteen pediatric patients received rituximab for FRNS/SDNS treatment were enrolled in a prospective, open-label, single-center PK study. A population PK model of rituximab was developed and validated, and PK parameters were derived for quantitative evaluation.Results: A two-compartment PK model best described the data. Body surface area was the most significant covariate for both central clearance (CL) and apparent central volume of distribution (V1). Patients with FRNS/SDNS exhibited a clinically relevant increase in rituximab CL compared to patient population with non-Hodgkin’s lymphoma (NHL).Conclusion: This pilot study indicated that higher doses or more frequent regimens of rituximab may be required for optimal therapeutic effects in patients with FRNS/SDNS. Further clinical studies with more patients are warranted to confirm this result.

Maintenance therapy with mycophenolate mofetil after rituximab in pediatric patients with steroid-dependent nephrotic syndrome

2011 ◽  
Vol 26 (10) ◽  
pp. 1823-1828 ◽  
Author(s):  
Shuichi Ito ◽  
Koichi Kamei ◽  
Masao Ogura ◽  
Mai Sato ◽  
Takuya Fujimaru ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Mycophenolate Mofetil ◽  
Maintenance Therapy ◽  
Pediatric Patients ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

scholarly journals Rituximab in Children with Steroid-Dependent Nephrotic Syndrome: A Multicenter, Open-Label, Noninferiority, Randomized Controlled Trial

2015 ◽  
Vol 26 (9) ◽  
pp. 2259-2266 ◽  
Author(s):  
Pietro Ravani ◽  
Roberta Rossi ◽  
Alice Bonanni ◽  
Robert R. Quinn ◽  
Felice Sica ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nephrotic Syndrome ◽  
Controlled Trial ◽  
Open Label ◽  
Randomized Controlled ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

scholarly journals Population Pharmacokinetics and Pharmacodynamic Implementation of Meropenem in Critically Ill Pediatric Patients

2020 ◽  
Author(s):  
Jumpei Saito ◽  
Kensuke Shoji ◽  
Yusuke Oho ◽  
Hiroki Kato ◽  
Shotaro Matsumoto ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pediatric Patients ◽  
Pediatric Intensive Care ◽  
Volume Of Distribution ◽  
Dosing Regimen ◽  
Final Model ◽  
The Mean ◽  
Higher Doses ◽  
Volumes Of Distribution ◽  
Significant Covariates

This study investigates the optimal meropenem (MEM) dosing regimen for critically ill pediatric patients, for which there is a lack of pharmacokinetic (PK) studies. We conducted a retrospective single-center PK and pharmacodynamic (PD) analysis of 34 pediatric intensive care unit patients who received MEM. Individual PK parameters were determined by a two-compartment analysis. The median (range) age and body weight were 1.4 (0.03–14.6) years old and 8.9 (2.7–40.9) kg, respectively, and eight (23.5%) patients received continuous renal replacement therapy (CRRT), of which three received extracorporeal membrane oxygenation. Renal function, systemic inflammatory response syndrome (SIRS) score, and the use of CRRT for central volumes of distribution (Vc) were identified as significant covariates. The mean clearance (CL), Vc, and peripheral volume of distribution (Vp) were 0.45 l/kg/h, 0.49 l/kg, and 0.34 l/kg, respectively. The mean population CL of MEM increased by 35% in patients with SIRS and Vc increased by 66% in patients on CRRT in the final model. Dosing simulations suggested that the standard dosing regimen provided insufficient PD exposures of 100% free time above the minimum inhibitory concentration, and higher doses (40–80 mg/kg/dose every 8 h) with a prolonged 3-h infusion were required to ensure the appropriate PD exposures for patients with SIRS. Our PK model indicated that critically ill pediatric patients are at risk of subtherapeutic exposure under the standard dosing regimen of MEM. A larger, prospective investigation confirming the safety and efficacy of higher concentrations and prolonged infusion of MEM is necessary.

Effectiveness and nephrotoxicity of a 2-year medium dose of cyclosporine in pediatric patients with steroid-dependent nephrotic syndrome: determination of the need for follow-up kidney biopsy

2017 ◽  
Vol 22 (2) ◽  
pp. 413-419 ◽  
Author(s):  
Yoshiyuki Kuroyanagi ◽  
Yoshimitsu Gotoh ◽  
Katsuaki Kasahara ◽  
China Nagano ◽  
Naoya Fujita ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Pediatric Patients ◽  
Kidney Biopsy ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome ◽  
Medium Dose

Efficacy of mycophenolate mofetil in pediatric patients with steroid-dependent nephrotic syndrome

2005 ◽  
Vol 20 (9) ◽  
pp. 1265-1268 ◽  
Author(s):  
Inna Novak ◽  
Rachel Frank ◽  
Suzanne Vento ◽  
Marcela Vergara ◽  
Bernard Gauthier ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Mycophenolate Mofetil ◽  
Pediatric Patients ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

A case of a 7-year-old boy with steroid-dependent nephrotic syndrome who developed severe neutropenia three months after the administration of rituximab

2009 ◽  
Vol 22 (2) ◽  
pp. 97-101 ◽  
Author(s):  
Ryugo Hiramoto ◽  
Shinsuke Matsumoto ◽  
Hironobu Eguchi ◽  
Yoshitaka Miyoshi ◽  
Isao Komori ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Severe Neutropenia ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

Short-term efficacy of rituximab versus tacrolimus in steroid-dependent nephrotic syndrome

2011 ◽  
Vol 27 (2) ◽  
pp. 235-241 ◽  
Author(s):  
Aditi Sinha ◽  
Arvind Bagga ◽  
Ashima Gulati ◽  
Pankaj Hari
Keyword(s):  
Nephrotic Syndrome ◽  
Short Term ◽  
Term Efficacy ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome

Mycophenolate sodium for children with frequently relapsing or steroid dependent nephrotic syndrome

2017 ◽  
Vol 54 (10) ◽  
pp. 885-886
Author(s):  
Kanika Kapoor ◽  
Abhijeet Saha ◽  
Manpreet Kaur ◽  
Nand Kishore Dubey ◽  
Ashish Datt Upadhyay
Keyword(s):  
Nephrotic Syndrome ◽  
Mycophenolate Sodium ◽  
Steroid Dependent ◽  
Steroid Dependent Nephrotic Syndrome
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