From the Research
The second dose of MabThera (rituximab) for nephrotic syndrome should typically be administered 2 weeks after the first dose, which would be around May 1st, based on the most recent and highest quality study available 1.
Key Points to Consider
- MabThera for nephrotic syndrome is commonly given as two infusions separated by 2 weeks, with each dose usually calculated based on body surface area (commonly 375 mg/m²) or as a fixed dose (such as 1 gram per infusion) 2, 1.
- This two-dose regimen helps achieve optimal B-cell depletion, which is the mechanism by which rituximab works to reduce proteinuria in nephrotic syndrome 3, 1.
- The medication targets CD20-positive B cells, reducing antibody production that contributes to kidney damage 4, 5.
- After receiving both doses, patients typically undergo monitoring of proteinuria levels and kidney function to assess response 2, 1.
- Some patients may require additional courses of treatment after 6-12 months if the disease relapses, but this depends on individual response and should be determined by the nephrologist 3, 1.
- Side effects should be monitored during and after each infusion, including infusion reactions, infections, and changes in blood counts 2, 5, 1.
Evidence Supporting the Recommendation
- A case series with extended follow-up found that combination therapy with rituximab, low-dose cyclophosphamide, and prednisone resulted in high rates of complete remission in patients with primary membranous nephropathy 1.
- Another study found that rituximab was non-inferior to cyclophosphamide as a first-line steroid-sparing agent in children with steroid-sensitive nephrotic syndrome 2.
- The most recent study available 1 provides the strongest evidence for the recommended treatment schedule, with a large sample size and extended follow-up period.