The effect of rituximab on the quality of life of children with refractory nephrotic syndrome
The effect of rituximab on the quality of life of children with refractory nephrotic syndrome
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DOI：
10.1111/ped.14725
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发表时间：
2021-12-02
影响因子：
1.4
通讯作者：
Ariga, Tadashi
中科院分区：
文献类型：
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作者：
Takahashi, Toshiyuki;Okamoto, Takayuki;Ariga, Tadashi
背景：利妥昔单抗(RTX)是维持肾病综合征(NS)患者缓解的有效药物，但有关RTX治疗对生活质量(QOL)影响的报道较少。本研究的目的是从生活质量的角度考察定期重复RTX治疗的效果。方法采用为期2年的RTX治疗方案，系统评价难治性NS患儿的生活质量及家长对子女生活质量的评价。纳入2015年1月至2015年12月间北海道大学医院收治的难治性NS患儿。RTX输注4次，每隔6个月一次，然后给予咪唑立宾，并早期停用钙调神经磷酸酶抑制剂。在每次给药时用儿科生活质量问卷4.0版(PedsQL)测量生活质量评分，并在2年后进行评估。结果分析22例患者的临床资料。在我们的两年治疗方案中，患者的生活质量和他们的父母对他们的生活质量的看法都有所改善。然而，父母的得分在所有量表上都低于患者的得分，进步较慢。结论我们的治疗方案对难治性NS患者的生活质量有显著改善。虽然应该考虑RTX治疗的风险，但这种治疗对难治性NS患者是有效的。
Background Rituximab (RTX) is an effective treatment for maintaining remission in patients with nephrotic syndrome (NS), but there are few reports on the effect of RTX treatment on quality of life (QOL). The purpose of this study was to examine the effect of periodically repeated RTX treatment from the perspective of QOL. Methods We systematically assessed the QOL of pediatric patients with refractory NS and parents' perceptions of their children's QOL through a 2 year RTX treatment protocol. Pediatric patients from Hokkaido University Hospital with refractory NS who met our specific criteria were enrolled between January 2015 and December 2015. The RTX infusion was performed 4 times at 6-month intervals, followed by mizoribine administration with early discontinuation of calcineurin inhibitors. Quality of life scores were measured by the Pediatric Quality of Life Inventory version 4.0 (PedsQL) at each RTX administration and evaluated 2 years later. Results Twenty-two patients were analyzed. The patients' QOL and their parents' perceptions of their QOL improved over our 2 year treatment protocol. Nevertheless, the parents' scores were lower than the patients' scores on all scales, with slower improvement. Conclusions Our treatment protocol showed a significant improvement of QOL in patients with refractory NS. Although the risk of the RTX treatment should be considered, the treatment is useful for patients with refractory NS.