Rituximab Therapy for Primary Membranous Nephropathy in a Chinese Cohort

Background: Rituximab has become one of the first-line therapies for the treatment of moderate and high-risk primary membranous nephropathy (pMN). We retrospectively reviewed 95 patients with pMN who received rituximab therapy and focused on the therapeutic effects and safety of this therapy in a Ch...

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Published in:Frontiers in medicine 2021-05, Vol.8, p.663680-663680
Main Authors: Gao, Shuang, Cui, Zhao, Wang, Xin, Zhang, Yi-miao, Wang, Fang, Cheng, Xu-yang, Meng, Li-qiang, Zhou, Fu-de, Liu, Gang, Zhao, Ming-hui
Format: Article
Language:English
Subjects:
anti-PLA2R antibody
CD20 monoclonal antibody
first line treatment
Medicine
primary membranous nephropathy
rituximab
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cited_by cdi_FETCH-LOGICAL-c439t-44128f03dcfdde382d35e48c51a6b9f800a66a36385844ab63c4356469ec00a03
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container_title Frontiers in medicine
container_volume 8
creator Gao, Shuang
Cui, Zhao
Wang, Xin
Zhang, Yi-miao
Wang, Fang
Cheng, Xu-yang
Meng, Li-qiang
Zhou, Fu-de
Liu, Gang
Zhao, Ming-hui
description Background: Rituximab has become one of the first-line therapies for the treatment of moderate and high-risk primary membranous nephropathy (pMN). We retrospectively reviewed 95 patients with pMN who received rituximab therapy and focused on the therapeutic effects and safety of this therapy in a Chinese cohort. Methods: Ninety-five consecutive patients with pMN diagnosed by kidney biopsy received rituximab and were followed up for >6 months. Four weekly doses of rituximab (375 mg/m 2 ) was adopted as the initial administration. Repeated single infusions were administrated to maintain B cell depletion levels of
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We retrospectively reviewed 95 patients with pMN who received rituximab therapy and focused on the therapeutic effects and safety of this therapy in a Chinese cohort. Methods: Ninety-five consecutive patients with pMN diagnosed by kidney biopsy received rituximab and were followed up for &gt;6 months. Four weekly doses of rituximab (375 mg/m 2 ) was adopted as the initial administration. Repeated single infusions were administrated to maintain B cell depletion levels of &lt;5 cells/mL. Results: A total of 91 patients completed rituximab therapy with the total dose of 2.4 (2.0, 3.0) g; 64/78 (82.1%) patients achieved anti-PLA2R antibody depletion in 6.0 (1.0, 12.0) months; 53/91 (58.2%) patients achieved clinical remission in 12.0 (6.0, 24.0) months, including complete remission in 18.7% of patients and partial remission in 39.6% of patients. Multivariate logistic regression analysis showed that severe proteinuria (OR = 1.22, P = 0.006) and the persistent positivity of anti-PLA2R antibodies (OR = 9.00, P = 0.002) were independent risk factors for no-remission. The remission rate of rituximab as an initial therapy was higher than rituximab as an alternative therapy (73.1 vs. 52.3%, P = 0.038). Lastly, 45 adverse events occurred in 37 patients, but only one patient withdrew from treatment due to severe pulmonary infection. 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We retrospectively reviewed 95 patients with pMN who received rituximab therapy and focused on the therapeutic effects and safety of this therapy in a Chinese cohort. Methods: Ninety-five consecutive patients with pMN diagnosed by kidney biopsy received rituximab and were followed up for &gt;6 months. Four weekly doses of rituximab (375 mg/m 2 ) was adopted as the initial administration. Repeated single infusions were administrated to maintain B cell depletion levels of &lt;5 cells/mL. Results: A total of 91 patients completed rituximab therapy with the total dose of 2.4 (2.0, 3.0) g; 64/78 (82.1%) patients achieved anti-PLA2R antibody depletion in 6.0 (1.0, 12.0) months; 53/91 (58.2%) patients achieved clinical remission in 12.0 (6.0, 24.0) months, including complete remission in 18.7% of patients and partial remission in 39.6% of patients. Multivariate logistic regression analysis showed that severe proteinuria (OR = 1.22, P = 0.006) and the persistent positivity of anti-PLA2R antibodies (OR = 9.00, P = 0.002) were independent risk factors for no-remission. The remission rate of rituximab as an initial therapy was higher than rituximab as an alternative therapy (73.1 vs. 52.3%, P = 0.038). Lastly, 45 adverse events occurred in 37 patients, but only one patient withdrew from treatment due to severe pulmonary infection. 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subjects anti-PLA2R antibody
CD20 monoclonal antibody
first line treatment
Medicine
primary membranous nephropathy
rituximab
title Rituximab Therapy for Primary Membranous Nephropathy in a Chinese Cohort
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