Table 5.

Summary of Included Studies of Podocytopathies (Listed in Chronological Order and Type of Study—All Are Induction Regimens).

Study	Type	Intervention/aim	Number of participants	RTX regimen	Concomitant immunosuppression	B-cell depletion reported	Study duration	Primary findings	Adverse events
Minimal change disease
Takei et al51 Japan	PCS	Assess the therapeutic effects of RTX in adult patients with GC dependent MCD	25	375 mg/m2 (maximum, 500 mg) ×2, 6 months apart	Tapering cyclosporine	Yes	12 months	A significant reduction in the number of relapses and the total/maintenance dose of GC when compared with the findings during the prior 12-month period (25 [100%] vs 4 [16%], P < .001; 8.2 vs 3.3 g, P < .001; 26.4 mg/day at baseline vs 1.1 mg/day at 12-month, P < .0001) CR achieved/maintained in 17/25 and 4/17 developed relapse	AE: 5 SAE: 0
Papakrivopoulou et al52 UK	PCS	Evaluate the efficacy and safety of RTX in maintaining remission, reducing relapse frequency and enabling withdrawal of immunosuppression, in frequently relapsing and steroid-dependent MCD	15	1000 mg ×2, 6 months apart	GC tapered by 3 month and CNI tapered after 12 months by 25% every 6 months	Yes	36 months	Median GC-free survival after RTX was 25 months (range, 4-34) Mean relapse frequency decreased from 2.60 ± 0.28 to 0.4 ± 0.19 (P < .001) after RTX Seven relapses occurred, 5 of which (71%) when CD19 counts were greater than 100 per μl.	AE: 9 SAE: 0
Minimal change disease and focal segmental glomerulosclerosis
Ruggenenti et al53 Italy	PCS	Evaluate the efficacy of RTX in reducing relapse and steroid exposure in children and adults with steroid-dependent or frequently relapsing NS due to MCD, MesGN, or FSGS	30 (adults: 20)	1-2 doses of rituximab (375 mg/m2/wk)	GC, CNI, MMF, CYC	Yes	1 year	At 1 year, all patients were in remission 18/30 (60%) were treatment-free 15/30 (50%) never relapsed Compared with the year pre-rituximab, total relapses decreased from 88 to 22 and per-patient median number of relapses decreased from 2.5 (IQR, 2–4) to 0.5 (IQR, 0–1; P = .001) per year	AE: 8 SAE: 8
Ren et al54 China	PCS	Investigate the therapeutic effects of RTX in patients with refractory MCD or FSGS	15	4 doses of rituximab (375 mg/m2/wk)	GC and other immunosuppressive medications allowed. All were tapered during the study	Yes	Median: 8 months (range, 3-36 months)	At 3 months: CR: 13/15 (87%) PR: 2/15 (13%) Relapses approximately 30-fold less compared with the year pre-RTX	AE: 0 SAE: 0
Ramachandran et al55 India	PCS	Describe the clinical outcome of adults with SD/SR NS treated with RTX	53	375 mg/m2 followed by 100 mg based on CD19 level after 2-3 days	GC and CNI	Yes	Median: 36 months (IQR 19-48)	CR: 44/53 (83%) PR: 6/53 (11%) 33/53 (62%) did not require steroid or CNI during the follow-up period	AE: 27 SAE: 0
Post-kidney transplant focal segmental glomerulosclerosis
Alasfar et al56 USA	PCS	Evaluate risk factors for posttransplant FSGS recurrence, describes its course, and determine the efficacy of RTX and TPE in its prevention and treatment	66	1 or 2 doses (375 mg/m2 per dose)	Perioperative TPE sessions were started anytime between day 7 before transplant to postoperative day 2 (3–10 sessions)	No	Median 29.5 months	23 /37 (62%) who received preventative therapy developed recurrence compared with 14/27 (51%) who did not receive any therapy (P = .21) There was a trend for less relapse when rituximab was used as a therapy for recurrent FSGS, (6/22 vs 9/18, P = .066)	Not mentioned

Note. RTX = rituximab; PCS = prospective cohort study; GC = glucocorticoids; wk = week; MCD = minimal change disease; CR = complete remission; AE = adverse events; SAE = severe adverse events; CNI = calcineurin inhibitor; NS = nephrotic syndrome; FSGS = focal segmental glomerulosclerosis; MMF = mycophenolate mofetil; CYC = cyclophosphamide; IQR = interquartile range; PR = partial remission; SD = steroid dependent; SR = steroid resistant; TPE = plasma exchange.