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Rituximab in Membranous Nephropathy.


ABSTRACT: Membranous nephropathy (MN) is the most common cause of primary nephrotic syndrome among adults. The identification of phospholipase A2 receptor (PLA2R) as target antigen in most patients changed the management of MN dramatically, and provided a rationale for B-cell depleting agents such as rituximab. The efficacy of rituximab in inducing remission has been investigated in several studies, including 3 randomized controlled trials, in which complete and partial remission of proteinuria was achieved in approximately two-thirds of treated patients. Due to its favorable safety profile, rituximab is now considered a first-line treatment option for MN, especially in patients at moderate and high risk of deterioration in kidney function. However, questions remain about how to best use rituximab, including the optimal dosing regimen, a potential need for maintenance therapy, and assessment of long-term safety and efficacy outcomes. In this review, we provide an overview of the current literature and discuss both strengths and limitations of "the new standard."

SUBMITTER: Gauckler P 

PROVIDER: S-EPMC8071613 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Rituximab in Membranous Nephropathy.

Gauckler Philipp P   Shin Jae Il JI   Alberici Federico F   Audard Vincent V   Bruchfeld Annette A   Busch Martin M   Cheung Chee Kay CK   Crnogorac Matija M   Delbarba Elisa E   Eller Kathrin K   Faguer Stanislas S   Galesic Kresimir K   Griffin Siân S   van den Hoogen Martijn W F MWF   Hrušková Zdenka Z   Jeyabalan Anushya A   Karras Alexandre A   King Catherine C   Kohli Harbir Singh HS   Mayer Gert G   Maas Rutger R   Muto Masahiro M   Moiseev Sergey S   Odler Balazs B   Pepper Ruth J RJ   Quintana Luis F LF   Radhakrishnan Jai J   Ramachandran Raja R   Salama Alan D AD   Schönermarck Ulf U   Segelmark Mårten M   Smith Lee L   Tesař Vladimír V   Wetzels Jack J   Willcocks Lisa L   Windpessl Martin M   Zand Ladan L   Zonozi Reza R   Kronbichler Andreas A  

Kidney international reports 20210113 4


Membranous nephropathy (MN) is the most common cause of primary nephrotic syndrome among adults. The identification of phospholipase A2 receptor (PLA2R) as target antigen in most patients changed the management of MN dramatically, and provided a rationale for B-cell depleting agents such as rituximab. The efficacy of rituximab in inducing remission has been investigated in several studies, including 3 randomized controlled trials, in which complete and partial remission of proteinuria was achiev  ...[more]

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