Ofatumumab in post‐transplantation recurrence of focal segmental glomerulosclerosis in a child

Solomon, Sonia; Zolotnitskaya, Anna; Río, Marcela Del

doi:10.1111/petr.13413

Cited by 18 publications

(14 citation statements)

References 22 publications

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“…The roles of pre-emptive plasmapheresis (pre and/or post-transplantation), immunoadsorption therapy, and other novel options such as ofatumumab or B7-1 blockers (abatacept and belatacept) to prevent disease recurrence or to treat recurrence appear promising but the efficacy of these treatments remain debatable and not always consistent or supported in subsequent studies (98–105). Ofatumumab, an anti-CD20 monoclonal antibody that induces profound B cell depletion appears promising in the prevention ( n = 1) and treatment ( n = 2, achieved partial remission) of recurrent FSGS occurring post-kidney transplant but this needs to be confirmed in large studies (103, 106, 107). The initial treatment success surrounding the efficacy of abatacept, an inhibitor of B7-1 co-stimulatory molecule in achieving clinical remission in 5 patients with FSGS (4 patients with rituximab-resistant recurrent FSGS post-kidney transplant and 1 patient with steroid-resistant primary FSGS; all with positive B7-1 immunostaining of podocytes) has not been corroborated in other cohorts (100).…”

Section: Introductionmentioning

confidence: 99%

Recurrent and de novo Glomerulonephritis After Kidney Transplantation

2019

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The prevalence, pathogenesis, predictors, and natural course of patients with recurrent glomerulonephritis (GN) occurring after kidney transplantation remains incompletely understood, including whether there are differences in the outcomes and advances in the treatment options of specific GN subtypes, including those with de novo GN. Consequently, the treatment options and approaches to recurrent disease are largely extrapolated from the general population, with responses to these treatments in those with recurrent or de novo GN post-transplantation poorly described. Given a greater understanding of the pathogenesis of GN and the development of novel treatment options, it is conceivable that these advances will result in an improved structure in the future management of patients with recurrent or de novo GN. This review focuses on the incidence, genetics, characteristics, clinical course, and risk of allograft failure of patients with recurrent or de novo GN after kidney transplantation, ascertaining potential disparities between “high risk” disease subtypes of IgA nephropathy, idiopathic membranous glomerulonephritis, focal segmental glomerulosclerosis, and membranoproliferative glomerulonephritis. We will examine in detail the management of patients with high risk GN, including the pre-transplant assessment, post-transplant monitoring, and the available treatment options for disease recurrence. Given the relative paucity of data of patients with recurrent and de novo GN after kidney transplantation, a global effort in collecting comprehensive in-depth data of patients with recurrent and de novo GN as well as novel trial design to test the efficacy of specific treatment strategy in large scale multicenter randomized controlled trials are essential to address the knowledge deficiency in this disease.

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Section: Introductionmentioning

confidence: 99%

Recurrent and de novo Glomerulonephritis After Kidney Transplantation

2019

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“…One patient had post-transplant recurrent FSGS (6,11). Gastrointestinal complications such as nausea, vomiting, and abdominal pain were reported in some studies (1,13,16).…”

Section: N 5 Study Selectionmentioning

confidence: 95%

“…Another 14 items were removed after reviewing the full text of papers because the topics did not fit our study subject. Finally, 11 studies were selected in our systematic review (1,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Figure 1 demonstrates the study selection approach.…”

Section: N 5 Study Selectionmentioning

confidence: 99%

A Systematic Review of Efficacy and Safety of Ofatumumab Therapy in Children With Difficult-to-treat Nephrotic Syndrome

et al. 2020

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Context: Different studies have been done so far on drug safety and efficacy in children with refractory nephrotic syndrome (NS). Ofatumumab might be an effective drug for this syndrome; however, the long-term effects and cost-effectiveness of ofatumumab treatment have not been comprehensively assessed. Objectives: This study aims to perform a systematic review of the efficacy and safety of ofatumumab in children with difficult-to-treat NS. Study Selection: An electronic literature search was conducted to identify appropriate studies. The search key terms were as follows: (“nephrotic syndrome” OR “minimal change disease” OR “focal segmental glomerulosclerosis” OR “membranous”) AND (“Ofatumumab” or “CD20” or “Arzerra” or “HuMax-CD20”). Data Extraction: Data were extracted from the articles according to the selection criteria by two independent reviewers. Results: A total of 83 potentially relevant articles were identified. Thirty-two articles were removed due to duplication. Then 26 more articles were excluded because they were book sections and review papers and therefore not relevant. Another 14 items were removed after reviewing the full text of selected papers because the topics did not fit our study subject. Finally, 11 studies were selected in our systematic review. The benchmark considered to assess the efficacy of ofatumumab in children with nephrotic syndrome in most of the studies was a complete remission rate. Conclusions: In conclusion, our systematic review showed that ofatumumab may be an effective drug in refractory NS treatment in children and could bring down the use of steroids and immunosuppressants. However, further large randomized trials are suggested.

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“…Even though u-PCR remained at 3-6 g/g, IAds were not reinitiated and creatinine remained stable at 100-110 umol/l with serum albumin > 30 g/l. Further reports on the use of OFA in the recurrence of FSGS postrenal transplant [15][16][17] demonstrated that patients were able to achieve partial or full remission. The details of these case reports can be found in Table 1.…”

Section: N D H a D R E C E I V E D C Y C L O P H O S P H A M I D E ( mentioning

confidence: 98%

The Use of Ofatumumab in Renal Conditions

Leow

2020

SN Compr. Clin. Med.

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Ofatumumab is a fully humanized monoclonal antibody against CD20. It has been initially used against hematological malignancies but now has been reported widely for autoimmune or rheumatological (e.g., rheumatoid arthritis, multiple sclerosis) and renal conditions. Over the past decade, since the first report on its use in rituximab-resistant nephrotic syndrome, there have been many more centers describing their experience with ofatumumab. Due to it being relatively new, the optimal dosing of ofatumumab for renal conditions has not been established, especially in children, and studies so far have been mainly case reports or case series. Large-scale, multi-center prospective studies are required to establish the appropriate dosing and investigate adverse reactions of ofatumumab. Reported studies on the use of ofatumumab in renal conditions and reported or potential adverse reactions are discussed in this review.

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Ofatumumab in post‐transplantation recurrence of focal segmental glomerulosclerosis in a child

Cited by 18 publications

References 22 publications

Recurrent and de novo Glomerulonephritis After Kidney Transplantation

Recurrent and de novo Glomerulonephritis After Kidney Transplantation

A Systematic Review of Efficacy and Safety of Ofatumumab Therapy in Children With Difficult-to-treat Nephrotic Syndrome

The Use of Ofatumumab in Renal Conditions

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