Rituximab: Dapatkah Dipakai Sebagai Terapi “Rescue†pada Sindrom Nefrotik Dependen Steroid Berat dan Dependen Siklosporin Serta Resisten Steroid pada Anak?
Sari
Pengobatan sindrom nefrotik dependen steroid (SNDS)/dependen siklosporin dan SN resisten steroid (SNRS)
sampai saat ini masih merupakan masalah di bidang Nefrologi anak karena belum ada yang memuaskan. Berbagai
obat supresi imun telah diberikan yaitu antara lain siklofosfamid (atau klorambusil), siklosporin A, mikofenolat
mofetil, takrolimus. Demikian pula levamisol hanya bersifat memperpanjang masa remisi sementara.
Penggunaan obat baru rituximab suatu antibodi monoklonal terhadap CD 20 sel B memberi harapan baru
pada pengobatan SNDS maupun SNRS, baik dengan gambaran histopatologi kelainan minimal (SNKM)
maupun glomerulosklerosis fokal segmental (GSFS). Dosis obat yang dipergunakan 375 mg/m2 per minggu
selama 4 minggu berturut-turut atau bahkan ada yang hanya 1-2 kali pemberian dapat menimbulkan remisi
total sampai beberapa bulan. Dalam makalah diuraikan studi literatur pengobatan SN secara kronologik
serta tingkat level of evidence dan kemungkinan penggunaan rituximab sebagai terapi rescue pada SNDS
berat/SNRS pada anak.
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DOI: http://dx.doi.org/10.14238/sp12.4.2010.260-4
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