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...

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Publicado en:Pediatric Nephrology Vol. 40; no. 11; pp. 3423 - 3437
Autores principales: Lan, Ning, Zhao, Chengguang, Wang, Li, Tang, Hanyun, Zhou, Weiran, Zhu, Hongtao, Li, Xiaoyan, Li, Yuhong, Xu, Ximing, Zhang, Gaofu
Formato: research tables/charts Journal Article
Publicado: Springer Nature Nov2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2025
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-025-06862-7
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        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
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