Low-dose rituximab improves progression in early-stage medium-to-high-risk membranous nephropathy:an exploratory study
10.12092/j.issn.1009-2501.2024.07.003
- VernacularTitle:小剂量利妥昔单抗改善早期中高风险膜性肾病疾病进展:一项探索性研究
- Author:
Qiuyu XU
1
;
Sanxi AI
;
Gangan WANG
;
Chunyu JIA
;
Jiahui WANG
;
Ke ZHENG
;
Yan QIN
;
Gang CHEN
;
Xuemei LI
Author Information
1. 中国医学科学院北京协和医学院北京协和医院肾内科,北京 100730
- Keywords:
idiopathic membranous nephropa-thy;
adult nephrotic syndrome;
B cell depletion therapy;
anti-CD20 monoclonal antibody;
anti-M-type phospholipase A2 receptor antibody
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2024;29(7):744-751
- CountryChina
- Language:Chinese
-
Abstract:
Membranous nephropathy(MN)is the predominant cause of primary nephrotic syn-drome(NS)among adults.The identification of PLA2R as target antigen has brought about a pro-found transformation in the management of MN,offering a basis for the utilization of B-cell deplet-ing agents such as rituximab(RTX).The question of whether early intervention targeting antibodies can effectively impede the progression of MN,contrib-uting to enhanced disease control and long-term renal outcomes for patients,remains further explo-ration.We analyzed demographic data,laboratory parameters,and renal involvement in 13 patients with PLA2R antibody-related MN who received at least one RTX treatment at our center from Octo-ber 2019 to March 2023.Early-stage medium-to-high-risk MN was defined as baseline or admission anti-PLA2R antibody levels exceeding 50 RU/mL,ex-cluding patients who already presented with ne-phrotic syndrome at baseline.The median duration of MN at the initiation of the first RTX treatment was 4.1 months(IQR 1-7.7),and the median follow-up time after RTX therapy was 27 months(IQR 23-45).All patients had commenced renin-angiotensin system inhibitors before receiving RTX.Following RTX therapy,none of the 13 patients progressed to NS during the follow-up period,and 12 patients achieved complete or partial remission at the 2-year follow-up or the last visit.No deaths,severe infections,or other serious adverse reactions oc-curred during the follow-up period.In conclusion,RTX demonstrates favorable efficacy and safety in early-stage,medium-to-high-risk MN patients.Initi-ating antibody clearance therapy in these patients may be beneficial for long-term disease control and distant renal outcomes.
