Chia-Shi Wang1,2,3, Rochelle Schmidt Liverman4, Rouba Garro5,4, Roshan Punnoose George5,4, Anastacia Glumova4, Alana Karp5,4, Stephanie Jernigan5,4, Barry Warshaw5,4. 1. Emory University School of Medicine, Atlanta, GA, USA. chia-shi.wang@emory.edu. 2. Children's Healthcare of Atlanta, Atlanta, GA, USA. chia-shi.wang@emory.edu. 3. Division of Pediatric Nephrology, Emory University School of Medicine, 2015 Uppergate Drive NE, Atlanta, GA, 30322-1015, USA. chia-shi.wang@emory.edu. 4. Children's Healthcare of Atlanta, Atlanta, GA, USA. 5. Emory University School of Medicine, Atlanta, GA, USA.
Abstract
BACKGROUND: Ofatumumab is a humanized anti-CD20 monoclonal antibody that has recently garnered interest as a potential therapeutic agent for nephrotic syndrome. We report our center's experience in administering ofatumumab to five pediatric patients with idiopathic nephrotic syndrome. METHODS: Between March 2015 and November 2016, five patients were treated with ofatumumab. One patient had post-transplant recurrent focal segmental glomerulosclerosis (FSGS) which had been resistant to plasmapheresis and numerous immunosuppressive agents. Four patients had nephrotic syndrome in their native kidneys, one with initial steroid-resistant disease and the others with subsequent development of steroid resistance. Two of the patients were treated with a desensitization protocol after experiencing hypersensitivity reactions to ofatumumab. RESULTS: One patient did not complete ofatumumab treatment due to infusion reactions. Of the four remaining patients, three achieved complete remission after treatment, and one achieved partial remission. One of the patients achieving complete remission represents the first reported case of successful treatment of post-transplant recurrent FSGS using ofatumumab. Two patients who received ofatumumab with our desensitization protocol were able to complete their treatments after initially experiencing hypersensitivity reactions. CONCLUSIONS: Ofatumumab may be an effective treatment for refractory childhood nephrotic syndrome and post-transplant recurrent FSGS. A desensitization protocol may be helpful to address hypersensitivity reactions.
BACKGROUND:Ofatumumab is a humanized anti-CD20 monoclonal antibody that has recently garnered interest as a potential therapeutic agent for nephrotic syndrome. We report our center's experience in administering ofatumumab to five pediatric patients with idiopathic nephrotic syndrome. METHODS: Between March 2015 and November 2016, five patients were treated with ofatumumab. One patient had post-transplant recurrent focal segmental glomerulosclerosis (FSGS) which had been resistant to plasmapheresis and numerous immunosuppressive agents. Four patients had nephrotic syndrome in their native kidneys, one with initial steroid-resistant disease and the others with subsequent development of steroid resistance. Two of the patients were treated with a desensitization protocol after experiencing hypersensitivity reactions to ofatumumab. RESULTS: One patient did not complete ofatumumab treatment due to infusion reactions. Of the four remaining patients, three achieved complete remission after treatment, and one achieved partial remission. One of the patients achieving complete remission represents the first reported case of successful treatment of post-transplant recurrent FSGS using ofatumumab. Two patients who received ofatumumab with our desensitization protocol were able to complete their treatments after initially experiencing hypersensitivity reactions. CONCLUSIONS:Ofatumumab may be an effective treatment for refractory childhood nephrotic syndrome and post-transplant recurrent FSGS. A desensitization protocol may be helpful to address hypersensitivity reactions.
Authors: Alice Bonanni; Marta Calatroni; Matteo D'Alessandro; Sara Signa; Enrica Bertelli; Michela Cioni; Eddi Di Marco; Roberto Biassoni; Gianluca Caridi; Giulia Ingrasciotta; Roberta Bertelli; Armando Di Donato; Maurizio Bruschi; Alberto Canepa; Giorgio Piaggio; Pietro Ravani; Gian Marco Ghiggeri Journal: Br J Clin Pharmacol Date: 2018-03-25 Impact factor: 4.335
Authors: Pietro Ravani; Manuela Colucci; Maurizio Bruschi; Marina Vivarelli; Michela Cioni; Armando DiDonato; Paolo Cravedi; Francesca Lugani; Francesca Antonini; Marco Prunotto; Francesco Emma; Andrea Angeletti; Gian Marco Ghiggeri Journal: J Am Soc Nephrol Date: 2021-09-20 Impact factor: 14.978
Authors: Aesha Maniar; David K Hooper; Christine B Sethna; Pamela Singer; Avram Traum; Elizabeth Benoit; Elizabeth Kotzen; Priya Verghese; Rouba Garro; Margaret Kamel; Daniel Ranch; Weiwen Shih; Namrata G Jain; Samhar Al-Akash Journal: Pediatr Transplant Date: 2021-07-11