Rituximab in Membranous Nephropathy

Philipp Gauckler*, Jae Il Shin, Federico Alberici, RITERM study group, Vincent Audard, Annette Bruchfeld, Martin Busch, Chee Kay Cheung, Matija Crnogorac, Elisa Delbarba, Kathrin Eller, Stanislas Faguer, Kresimir Galesic, Siân Griffin, Martijn W.F. van den Hoogen, Zdenka Hrušková, Anushya Jeyabalan, Alexandre Karras, Catherine King, Harbir Singh KohliGert Mayer, Rutger Maas, Masahiro Muto, Sergey Moiseev, Balazs Odler, Ruth J. Pepper, Luis F. Quintana, Jai Radhakrishnan, Raja Ramachandran, Alan D. Salama, Ulf Schönermarck, Mårten Segelmark, Lee Smith, Vladimír Tesař, Jack Wetzels, Lisa Willcocks, Martin Windpessl, Ladan Zand, Reza Zonozi, Andreas Kronbichler

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

13 Citations (Scopus)
11 Downloads (Pure)

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.”

Original languageEnglish
Pages (from-to)881-893
Number of pages13
JournalKidney International Reports
Volume6
Issue number4
DOIs
Publication statusPublished - 1 Apr 2021

Bibliographical note

Publisher Copyright: © 2021

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