Analysis on the efficacy and safety of rituximab in treatment of refractory primary focal segmental glomerulosclerosis in adults

GUAN Lisi; YE Kun; WEI Qiaoyu; DENG Meiqiu; HUANG Shaorong

doi:10.3969/j.issn.1674-3806.2025.12.06

Abstract：Objective To analyze the efficacy and safety of rituximab(RTX)in treatment of refractory primary focal segmental glomerulosclerosis(FSGS)in adults.Methods The clinical data of 14 adult patients who were diagnosed with refractory primary FSGS and received RTX treatment in Department of Nephrology,the People's Hospital of Guangxi Zhuang Autonomous Region from January 1,2021 to July 31,2025 were retrospectively analyzed.These data were sourced from the electronic medical record system of the People's Hospital of Guangxi Zhuang Autonomous Region and the follow-up records of the patients.Results The pathological types included 12 cases of non-specific type and 2 cases of apical type.The median age of the patients receiving RTX treatment for the first time was 37.5(23.0,69.5)years.Nine patients received single-dose treatment and 5 patients received 2-dose treatment,and the regular follow-up was completed in all the patients.At the 6-month follow-up,9 patients achieved complete remission and 5 patients achieved partial remission.Three FSGS patients with steroid-resistant type achieved complete remission at the sixth month of RTX treatment.Three overweight patients and one obese patient were treated with a single dose of RTX and all of them achieved complete remission 6 months after RTX treatment.During the follow-up period,all the patients did not experience any drug-related adverse reactions.Conclusion A single dose of RTX is not only effective for adult patients with steroid-dependent type and frequently relapsing type of FSGS,but also applicable to steroid-resistant type of FSGS.The therapeutic response to a single dose of RTX in overweight and obese patients may not be significantly different from that in normal-weight and underweight patients.After RTX treatment,the patients need to be closely followed up and attention should be paid to preventing infection in them.