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Rituximab may induce proteinuria remission for non-responsive idiopathic membranous nephropathy
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Rituximab therapy in patients with non-responsive idiopathic membranous nephropathy may induce proteinuria remission and renal function stabilization. The results may even hold for patients with damaged renal function, according to results published in Nephrology Dialysis Transplantation.
In a Chinese cohort, researchers enrolled 36 patients with idiopathic membranous nephropathy who were non-responsive to prior immunosuppression. Rituximab for B-cell depletion was administered in all patients. The goal was for patients to have fewer than five B cells/mm³ in circulation. Patients were monitored for a median of 12 months after completion of the study.
Results showed of the 36 patients, 15 patients achieved partial or complete response to the rituximab. Investigators noted 4 months was the median time to achieve partial response. Before the rituximab treatment, responders had lower levels of anti-phospholipase 2 receptor (anti-PLA2R) antibodies and all achieved either antibody depletion or reduction. All patients achieved B-cell depletion. Renal function remained stable in responders; however, it worsened in non-responders.
There were two patients who reached end-stage kidney disease. Of the 15 patients, two patients relapsed during the follow-up with anti-PLA2R antibody recurrence and B-cell restitution. A faster partial response was seen in one patient after the second round of rituximab with tacrolimus. – by Monica Jaramillo
Disclosure: The study was supported by grants from the Natural Science Foundation of China to the Innovation Research Group.
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