Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome
Objectives: Rituximab is frequently used off-label for the treatment of frequent-relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS), but the relapse rate remained high and the dosing regimen varied widely. The objective of this study was to characterize rituximab phar...
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.725665/full |
| _version_ | 1818667224082153472 |
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| author | Yewei Chen Qian Shen Min Dong Min Dong Ye Xiong Hong Xu Zhiping Li |
| author_facet | Yewei Chen Qian Shen Min Dong Min Dong Ye Xiong Hong Xu Zhiping Li |
| author_sort | Yewei Chen |
| collection | DOAJ |
| description | Objectives: Rituximab is frequently used off-label for the treatment of frequent-relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS), but the relapse rate remained high and the dosing regimen varied widely. The objective of this study was to characterize rituximab pharmacokinetics (PK) in pediatric patients with FRNS/SDNS, and to investigate the differences in rituximab PK between patients with FRNS/SDNS and other disease populations.Methods: Fourteen pediatric patients received rituximab for FRNS/SDNS treatment were enrolled in a prospective, open-label, single-center PK study. A population PK model of rituximab was developed and validated, and PK parameters were derived for quantitative evaluation.Results: A two-compartment PK model best described the data. Body surface area was the most significant covariate for both central clearance (CL) and apparent central volume of distribution (V1). Patients with FRNS/SDNS exhibited a clinically relevant increase in rituximab CL compared to patient population with non-Hodgkin’s lymphoma (NHL).Conclusion: This pilot study indicated that higher doses or more frequent regimens of rituximab may be required for optimal therapeutic effects in patients with FRNS/SDNS. Further clinical studies with more patients are warranted to confirm this result. |
| first_indexed | 2024-12-17T06:17:01Z |
| format | Article |
| id | doaj.art-e33644054cb34617982fc357bf7a5b2a |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-17T06:17:01Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-e33644054cb34617982fc357bf7a5b2a2022-12-21T22:00:29ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-09-011210.3389/fphar.2021.725665725665Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic SyndromeYewei Chen0Qian Shen1Min Dong2Min Dong3Ye Xiong4Hong Xu5Zhiping Li6Department of Pharmacy, Children’s Hospital of Fudan University, Shanghai, ChinaDepartment of Nephrology, Children’s Hospital of Fudan University, Shanghai, ChinaDivision of Clinical Pharmacology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United StatesDepartment of Pediatrics, University of Cincinnati, Cincinnati, OH, United StatesDivision of Clinical Pharmacology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United StatesDepartment of Nephrology, Children’s Hospital of Fudan University, Shanghai, ChinaDepartment of Pharmacy, Children’s Hospital of Fudan University, Shanghai, ChinaObjectives: Rituximab is frequently used off-label for the treatment of frequent-relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS), but the relapse rate remained high and the dosing regimen varied widely. The objective of this study was to characterize rituximab pharmacokinetics (PK) in pediatric patients with FRNS/SDNS, and to investigate the differences in rituximab PK between patients with FRNS/SDNS and other disease populations.Methods: Fourteen pediatric patients received rituximab for FRNS/SDNS treatment were enrolled in a prospective, open-label, single-center PK study. A population PK model of rituximab was developed and validated, and PK parameters were derived for quantitative evaluation.Results: A two-compartment PK model best described the data. Body surface area was the most significant covariate for both central clearance (CL) and apparent central volume of distribution (V1). Patients with FRNS/SDNS exhibited a clinically relevant increase in rituximab CL compared to patient population with non-Hodgkin’s lymphoma (NHL).Conclusion: This pilot study indicated that higher doses or more frequent regimens of rituximab may be required for optimal therapeutic effects in patients with FRNS/SDNS. Further clinical studies with more patients are warranted to confirm this result.https://www.frontiersin.org/articles/10.3389/fphar.2021.725665/fullrituximabpharmacokineticschildrennephrotic syndromedosing |
| spellingShingle | Yewei Chen Qian Shen Min Dong Min Dong Ye Xiong Hong Xu Zhiping Li Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome Frontiers in Pharmacology rituximab pharmacokinetics children nephrotic syndrome dosing |
| title | Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome |
| title_full | Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome |
| title_fullStr | Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome |
| title_full_unstemmed | Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome |
| title_short | Population Pharmacokinetics of Rituximab in Pediatric Patients With Frequent-Relapsing or Steroid-Dependent Nephrotic Syndrome |
| title_sort | population pharmacokinetics of rituximab in pediatric patients with frequent relapsing or steroid dependent nephrotic syndrome |
| topic | rituximab pharmacokinetics children nephrotic syndrome dosing |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2021.725665/full |
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