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Abstract: TH-PO159

High Doses of Rituximab Are Ineffective in Adult Patients with Focal Segmental Glomerulosclerosis

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders


  • Roccatello, Dario, Ospedale San GIovanni Bosco, Torino, Italy
  • Sciascia, Savino, Center of Research of Immunopathology and Rare Diseases (CMID), Division of Clinical Immunology, Giovanni Bosco Hospital and University of Turin, Ita, Torino, Italy
  • Fenoglio, Roberta, Ospedale San GIovanni Bosco, Torino, Italy

a beneficial effect of rituximab on Focal Segmental Glomerulosclerosis (FSGS) in pediatric patients or in transplant recipients has been reported in isolated cases. However, the use of Rituximab in adult patients with idiopathic FSGS needs further investigation.


Eight patients who had biopsy-proven FSGS (63.9±14.0, range 40-81 yr, 4 women, 4 men) with major risk factors precluding corticosteroids or conventional immunosuppression were treated with high dose of rituximab (8 weekly doses of 375mg/m2) and prospectively followed up for at least 2 years (29.1 ± 8.8 mo, range 24 to 42 mo).


Rituximab failed to improve proteinuria in seven out of 8 patients, who had persistent nephrotic proteinuria. In one case, a rapidly deteriorating renal function was also observed. Only one patient showed an improvement of renal function and a remarkable proteinuria reduction. There were no differences in clinical or laboratory characteristics or in the CD20 B lymphocyte count after rituximab between the responder and the 7 non responders patients


Only a minority (one of eight) in our series of adult patients with FSGS showed positive effects of high doses of rituximab. Future studies are warranted to investigate more promising therapeutic options in the management of FSGS.