Combination Therapy With Rituximab and Low-Dose Cyclophosphamide and Prednisone in Membranous Nephropathy
A prospective cohort testing a vasculitis-style triple regimen of rituximab plus low-dose cyclophosphamide and prednisone achieved rapid immunological remission in 88% of high-risk membranous nephropathy patients within 8 weeks, with mostly mild side effects.
Study design
This single-arm prospective cohort enrolled 26 high-risk, anti-PLA2R-positive patients with membranous nephropathy and applied a vasculitis-derived low-dose regimen (rituximab 2 x 1000 mg, cyclophosphamide 1.5 mg/kg/day for 8 weeks, and prednisone), tracking PLA2R antibody kinetics.
Key findings
Immunological remission (antibodies <14 RU/ml) reached 88% within 8 weeks, and proteinuria remission developed in 21 of 26 patients after initial therapy, with remission in all 7 who received renewed therapy. High baseline antibody levels and a longer antibody half-life (>7 days at 4 weeks) identified patients needing additional treatment.
Safety
Serious adverse events occurred in 4 patients; adverse events were generally mild, with leukopenia the most frequent.
Category
Research
Source
Kidney International Reports
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