Table 2.
Reports of adverse events related to infection after anti-CD20 use in kidney disease in children from prospective studies
| Study | Study Design | Disease | Anti-CD20 | No. of Patients Analysed | No. of anti-CD20 courses | Regimen per Course mg/m2 | Infections, episodes | Serious Infections, episodes | Upper respiratory tract infection | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| anti-CD20 | Control | anti-CD20 | Control | anti-CD20 | |||||||
| Brogan et al., 2022 [43] | Prospective | AAV | Rituximab | 25 | 25 | 1500 | 105 | - | 9 | - | 41 |
| Guigonis et al., 2008 [44] | Prospective | SDNS and SRNS | Rituximab | 22 | 40 | 375–1500 | NR | - | 2 | - | NR |
| Kamei et al., 2009 [45] | Prospective | Refractory SDNS | Rituximab | 12 | 22 | 375–1500 | NR | - | NR | - | NR |
| Ravani et al., 2011 [46] | RCT | NS | Rituximab | 54 | 27 | 375–750 | NR | NR | NR | NR | NR |
| Magnasco et al., 2012 [47] | RCT | NS | Rituximab | 31 | 16 | 750 | NR | NR | NR | NR | NR |
| Ravani et al., 2013 [48] | Prospective | NS | Rituximab | 46 | 104 | 375–750 | NR | - | 3 | - | NR |
| Iijima et al., 2014 [7] | DBRCT | FRNS and SDNS | Rituximab | 48 | 24 | 1500 | 105 | 42 | 4a | 0 | NR |
| Ruggenenti et al., 2014 [5] | Prospective | FRNS and SDNS | Rituximab | 10 | 10 | 375–750 | NR | - | 0 | - | 0c |
| Sun et al., 2014 [49] | Prospective | SDNS, FRNS, and SRNS | Rituximab | 12 | 12 | 375–750 | 3 | - | 0 | - | 2 |
| Ravani et al., 2015 [8] | RCT | SDNS | Rituximab | 30 | 15 | 375 | NR | NR | NR | NR | NR |
| Ahn et al., 2018 [50] | RCT | SDNS | Rituximab | 51 | 35 | 375–750 | 21 | 4 | NR | NR | NR |
| Prospective | SRNS | Rituximab | 23 | 23 | 375–750 | 16 | - | NR | - | NR | |
| Basu et al., 2018 [51] | RCT | CDNS | Rituximab | 120 | 60 | 750–1500 | 13b | 26b | 2 | 2 | 4b |
| Takahashi et al., 2019 [52] | Prospective | FRNS and SDNS | Rituximab | 22 | 22 | 1500 | 25 | - | 1 | - | 8 |
| Kari et al., 2020 [53] | Prospective | SSNS | Rituximab | 46 | 19 | 750 | NR | NR | NR | NR | NR |
| Ravani et al., 2020 [54] | RCT | SDNS | Rituximab | 30 | 15 | 375 | NR | NR | NR | NR | NR |
| Ravani et al., 2020 [55] | RCT | MRNS | Ofatumumab | 13 | 7 | 1500mg/1.73 m2 | NR | NR | NR | NR | NR |
| Ravani et al., 2021 [56] | RCT | SDNS | Ofatumumab | 140 | 140 | 375 | NR | NR | NR | NR | NR |
| Ravani et al., 2021 [57] | RCT | SDNS | Rituximab | 30 | 15 | 375 | NR | NR | NR | NR | NR |
| Al Salloum et al., 2022 [58] | Prospective | SDNS | Rituximab | 17 | 23 | 750–1500 | NR | - | 1 | - | NR |
| Mathew et al., 2022 [59] | RCT | SSNS | Rituximab | 41 | 21 | 750 | 86 | 67 | 2 | 2 | 64 |
| Wang et al., 2022 [60] | 3-arm RCT | FRSDNS | Rituximab | 51 | 17 | 562.5–750.5 | 19 | 71 | NR | NR | NR |
| Basu et al., 2023 [61] | Prospective | SDNS | Rituximab | 119 | 89 | 750 | NR | NR | NR | NR | NR |
| Zhu et al., 2023 [62] | RCT | FRNS and SDNS | Rituximab | 29 | 29 | 775–1500 | 17 | - | NR | - | NR |
| Cravedi et al., 2024 [63] | Prospective | SDNS | Rituximab | 13 | 13 | 375 | 0 | - | 0 | - | 0 |
| Liu et al., 2024 [64] | Prospective | SSNS | Rituximab | 76 | 43 | 375 | 15b | NR | 4 | NR | 10b |
| Nozu et al., 2024 [65] | Prospective | MRNS | Rituximab | 6 | 6 | 1500 | 8 | - | 2 | - | NR |
| Sheng et al., 2025 [66] | RCT | NS | Rituximab | 24 | 12 | 1500 | NR | NR | 0 | 0 | 2a |
| Sinha et al., 2025 [67] | RCT | FRNS and SDNS | Rituximab | 91 | 91 | 375–750 | NR | - | 5 | - | NR |
| Billing et al., 2008 [68] | Prospective | AMR | Rituximab | 6 | 6 | 375 | 0 | - | 0 | - | 0 |
| Zarkhin et al., 2008 [69] | RCT | AMR | Rituximab | 20 | 10 | 1500 | NR | NR | NR | NR | NR |
| Billing et al., 2012 [70] | Prospective | AMR | Rituximab | 20 | 20 | 375 | NR | - | 1 | - | NR |
| Total | 1278 | 1011 | 405/233 | 184/94 | 32/508 | 4/116 | 115/99 | ||||
| Episodes per rituximab course | 1.74 | 1.96 | 0.06 | 0.03 | 1.16 | ||||||
| Study | Upper respiratory tract infection | Lower respiratory tract infection | Urinary tract infection | Herpes simplex virus related | Gastrointestinal infection | Sepsis/bloodstream infection | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Control | anti-CD20 | Control | anti-CD20 | Control | anti-CD20 | Control | anti-CD20 | Control | anti-CD20 | Control | |
| Brogan et al., 2022 [43] | - | 5 | - | 3 | - | NR | - | 3 | - | 1 | - |
| Guigonis et al., 2008 [44] | - | 1 | - | NR | - | NR | - | 1 | - | NR | - |
| Kamei et al., 2009 [45] | - | NR | - | NR | - | NR | - | NR | - | NR | - |
| Ravani et al., 2011 [46] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Magnasco et al., 2012 [47] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Ravani et al., 2013 [48] | - | NR | - | 1ac | - | NR | - | NR | - | NR | - |
| Iijima et al., 2014 [7] | NR | NR | NR | 1ac | 0ac | NR | NR | 1ac | 0ac | NR | NR |
| Ruggenenti et al., 2014 [5] | - | NR | - | NR | - | NR | - | 0c | - | NR | - |
| Sun et al., 2014 [49] | - | 1 | - | NR | - | NR | - | NR | - | NR | - |
| Ravani et al., 2015 [8] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Ahn et al., 2018 [50] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| - | NR | - | NR | - | NR | - | NR | - | NR | - | |
| Basu et al., 2018 [51] | 6b | 4b | 8b | 0b | 2b | 1b | 0b | 3b | 5b | NR | NR |
| Takahashi et al., 2019 [52] | - | 1 | - | NR | - | NR | - | NR | - | NR | - |
| Kari et al., 2020 [53] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Ravani et al., 2020 [54] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Ravani et al., 2020 [55] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Ravani et al., 2021 [56] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Ravani et al., 2021 [57] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Al Salloum et al., 2022 [58] | - | 1 | - | NR | - | NR | - | NR | - | NR | - |
| Mathew et al., 2022 [59] | 47 | 1 | 2 | NR | NR | NR | NR | 5 | 0 | NR | NR |
| Wang et al., 2022 [60] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Basu et al., 2023 [61] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Zhu et al., 2023 [62] | - | NR | - | NR | - | NR | - | NR | - | NR | - |
| Cravedi et al., 2024 [63] | - | 0 | - | 0 | - | 0 | - | 0 | - | 0 | - |
| Liu et al., 2024 [64] | NR | 5b | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Nozu et al., 2024 [65] | - | NR | - | NR | - | NR | - | NR | - | NR | - |
| Sheng et al., 2025 [66] | 0 | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Sinha et al., 2025 [67] | - | NR | - | 1 | - | NR | - | NR | - | 1 | - |
| Billing et al., 2008 [68] | - | 0 | - | 0 | - | 0 | - | 0 | - | 0 | - |
| Zarkhin et al., 2008 [69] | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Billing et al., 2012 [70] | - | 1 | - | NR | - | NR | - | NR | - | NR | - |
| Total | 47/32 | 11/182 | 2/20 | 4/135 | - | 0/19 | - | 9/105 | 0/20 | 2/135 | - |
| Episodes per rituximab course | 1.47 | 0.06 | 0.10 | 0.03 | - | 0.00 | - | 0.09 | 0.00 | 0.01 | - |
Only AEs without grade scale were included for calculation. No case related to varicella zoster virus, hepatitis B reactivation, cytomegalovirus, Epstein-Barr virus, BK virus, and death due to infection was reported from prospective studies. Therefore, the data of them are not shown
RCT randomised controlled trials, AAV ANCA-associated vasculitis, SDNS steroid dependent nephrotic syndrome, SRNS steroid resistant nephrotic syndrome, FRNS frequently relapse nephrotic syndrome, MRNS multiple drug-resistant nephrotic syndrome, FRSDNS frequently-relapsing steroid-dependent nephrotic syndrome, NR not reported
aReported by the number of subjects
bGrades 2–4
cGrades 3–4