Conclusions and Future Perspectives

Conclusions and Future Perspectives

Rituximab is a promising option for the treatment of
complicated FRNS/SDNS. However, this drug does not
cure nephrotic syndrome because all of the patients in the
RNRNS01 trial had relapsed by 19 months [34 •• ]. To
extend the relapse-free period, further modification of
rituximab therapy, including repeated courses and adjunct
immunosuppressive therapies, may be necessary. Indeed,
a multicenter, double-blind, randomized, placebo-con-
trolled trial to examine the efficacy and safety of myco-
phenolate mofetil after rituximab therapy for treatment of
complicated FRNS/SDNS in children will be started in
2015 in Japan. Moreover, comparison of the efficacy,
safety, and cost-effectiveness of various rituximab dosing
regimens and B-cell-driven regimens remains to be
examined [54]. Further studies are required to examine
the long-term effects of rituximab use, particularly in
children. A retrospective long-term follow-up study of
patients enrolled in RCRNS01 and RCRNS02, focusing
on clinical courses, treatments after the clinical trial,
growth, and late adverse effects, will be carried out soon
in Japan. At present, there is no evidence that rituximab is
effective in patients with refractory SRNS. However,
Kamei et al. recently reported that additional rituximab
combined with conventional methylprednisolone pulse
therapy and immunosuppressive agents is a promising
option for overcoming refractory SRNS [55]. A multi-
center, single-arm trial to examine efficacy and safety of
rituximab combined with methylprednisolone pulse ther-
apy and immunosuppressive agents will be started in 2015
in Japan.

Hasil (Bahasa Indonesia) 1:

Conclusions and Future PerspectivesRituximab is a promising option for the treatment ofcomplicated FRNS/SDNS. However, this drug does notcure nephrotic syndrome because all of the patients in theRNRNS01 trial had relapsed by 19 months [34 •• ]. Toextend the relapse-free period, further modification ofrituximab therapy, including repeated courses and adjunctimmunosuppressive therapies, may be necessary. Indeed,a multicenter, double-blind, randomized, placebo-con-trolled trial to examine the efficacy and safety of myco-phenolate mofetil after rituximab therapy for treatment ofcomplicated FRNS/SDNS in children will be started in2015 in Japan. Moreover, comparison of the efficacy,safety, and cost-effectiveness of various rituximab dosingregimens and B-cell-driven regimens remains to beexamined [54]. Further studies are required to examinethe long-term effects of rituximab use, particularly inchildren. A retrospective long-term follow-up study ofpatients enrolled in RCRNS01 and RCRNS02, focusingon clinical courses, treatments after the clinical trial,growth, and late adverse effects, will be carried out soonin Japan. At present, there is no evidence that rituximab iseffective in patients with refractory SRNS. However,Kamei et al. recently reported that additional rituximabcombined with conventional methylprednisolone pulsetherapy and immunosuppressive agents is a promisingoption for overcoming refractory SRNS [55]. A multi-Pusat, single-lengan percobaan untuk menguji efektivitas dan keamananrituximab dikombinasikan dengan methylprednisolone pulsa ada-agen APY dan imunosupresif akan dimulai pada tahun 2015di Jepang.

Hasil (Bahasa Indonesia) 2:

Kesimpulan dan Masa Depan Perspektif Rituximab adalah pilihan yang menjanjikan untuk pengobatan rumit SNKS / SDN. Namun, obat ini tidak menyembuhkan sindrom nefrotik karena semua pasien dalam percobaan RNRNS01 kambuh oleh 19 bulan [34 ••]. Untuk memperpanjang masa kambuh-bebas, modifikasi lebih lanjut dari terapi rituximab, termasuk kursus berulang dan tambahan terapi imunosupresif, mungkin diperlukan. Memang, multicenter, double-blind, acak, plasebo-con- dikendalikan percobaan untuk menguji efektivitas dan keamanan cendawan fenolat mofetil setelah terapi rituximab untuk pengobatan rumit SNKS / SDN pada anak-anak akan dimulai pada 2015 di Jepang. Selain itu, perbandingan efikasi, keamanan, dan efektivitas biaya berbagai dosis rituximab rejimen dan rejimen B-sel didorong masih harus diperiksa [54]. Penelitian lebih lanjut diperlukan untuk menguji efek jangka panjang dari penggunaan rituximab, khususnya di anak-anak. Sebuah studi tindak lanjut jangka panjang retrospektif dari pasien yang terdaftar dalam RCRNS01 dan RCRNS02, dengan fokus pada program klinis, perawatan setelah uji klinis, pertumbuhan, dan efek samping terlambat, akan dilakukan segera di Jepang. Saat ini, tidak ada bukti bahwa rituximab adalah efektif pada pasien dengan refraktori SRNS. Namun, Kamei dkk. baru-baru ini melaporkan bahwa rituximab tambahan dikombinasikan dengan pulsa methylprednisolone konvensional terapi dan agen imunosupresif adalah menjanjikan pilihan untuk mengatasi refraktori SRNS [55]. Sebuah multi center, kelompok tunggal percobaan untuk menguji efektivitas dan keamanan rituximab dikombinasikan dengan methylprednisolone pulsa terapi dari APY dan imunosupresif agen akan dimulai pada tahun 2015 di Jepang.