Parental perspectives on the effectiveness and safety of rituximab in treating pediatric nephrotic syndrome: a nationwide multi-center survey study.
Background: Rituximab is increasingly used for steroid-dependent/frequently relapsing nephrotic syndrome, yet parental perspectives on its real-world impact remain understudied. This study evaluated parental perceptions of rituximab's effectiveness, safety, and socioeconomic effects. Methods: A nati...
| Publicado en: | Pediatric Nephrology Vol. 40; no. 11; pp. 3423 - 3437 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Nov2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=188353557&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 188353557 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Nov2025 vid: 40 iid: 11 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 188353557 186153694 188353557 188353557 10.1007/s00467-025-06862-7 188353557 ppf: 3423 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Parental perspectives on the effectiveness and safety of rituximab in treating pediatric nephrotic syndrome: a nationwide multi-center survey study. aug: au: Lan, Ning Zhao, Chengguang Wang, Li Tang, Hanyun Zhou, Weiran Zhu, Hongtao Li, Xiaoyan Li, Yuhong Xu, Ximing Zhang, Gaofu affil: https://ror.org/05pz4ws32 Department of Nephrology, Children's Hospital of Chongqing Medical University sug: subj: Rituximab Therapeutic Use Nephrotic Syndrome Drug Therapy Parents Psychosocial Factors Drug Efficacy Patient Safety Socioeconomic Factors Human Multicenter Studies Cross Sectional Studies China Financial Stress Health Care Costs Caregiver Burden Health Services Accessibility Multivariate Statistics Regression Patient Satisfaction Psychological Well-Being Descriptive Statistics Immunosuppression Caregivers Psychosocial Factors Quality of Life Structured Questionnaires Questionnaires Data Analysis Software Pearson's Correlation Coefficient Chi Square Test Fisher's Exact Test Wilcoxon Rank Sum Test Univariate Statistics Multivariate Analysis Logistic Regression Odds Ratio Confidence Intervals Adult Middle Age Child Adult: 19-44 years Middle Aged: 45-64 years Child: 6-12 years ab: Background: Rituximab is increasingly used for steroid-dependent/frequently relapsing nephrotic syndrome, yet parental perspectives on its real-world impact remain understudied. This study evaluated parental perceptions of rituximab's effectiveness, safety, and socioeconomic effects. Methods: A nationwide cross-sectional survey was conducted across eight pediatric centers in China (Feb 2025). Validated questionnaires were administered to 570 parents of children with nephrotic syndrome, assessing rituximab efficacy, safety, financial burden, caregiver quality of life (SF-36), and treatment barriers. Multivariable regression models analyzed predictors of treatment satisfaction and parental well-being. Results: Among 489 parents analyzed, 232 children (47.4%) received rituximab. Most parents (79.3%) reported good disease control, and 90.5% perceived overall improvement, with 10.3% achieving sustained complete remission without relapse after rituximab treatment. Regarding safety, 86.2% of parents observed no increase in respiratory infections, and 98.3% reported improved child quality of life. Financial burden influenced perceptions; parents from households earning < $3000 annually were less satisfied with rituximab efficacy (OR = 0.22, 95% CI: 0.08–0.60, P = 0.004). Higher SF-36 scores were reported by parents of children who discontinued steroids or had significant quality-of-life improvements. Immune suppression concerns (80.6%) and high costs remained major barriers. Conclusions: This study demonstrates favorable parental perceptions of rituximab regarding efficacy, safety, and caregiver quality of life in patients with pediatric nephrotic syndrome. However, financial challenges and safety concerns limit its broader use. Policy interventions should prioritize financial subsidies, expand insurance coverage, and implement multidisciplinary support programs to address caregivers' psychosocial needs. Enhanced pre-treatment counseling and steroid-sparing protocols may further optimize parental satisfaction and treatment outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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