Therapy of relapsing minimal-change disease in adults: a new approach?

Multiple-relapsing minimal-change disease (MCD) often requires exposure to potentially toxic agents in an attempt to achieve a lasting remission of nephrotic syndrome. Munyentwali and co-workers describe an experience using rituximab in adults with multiple-relapsing MCD that supports both efficacy and safety of this agent. However, the optimal dosing regimen and mechanism of action remain unclear. Thus, randomized controlled trials are warranted in both adults and children to better define the role of rituximab in multiple-relapsing MCD.