ArticleKidney international reports2021
Long-Term Follow-Up of Cyclical Cyclophosphamide and Steroids Versus Tacrolimus and Steroids in Primary Membranous Nephropathy.
Article in Kidney international reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Efficacy and safety of glucocorticoid combined with cyclophosphamide therapy on membranous nephropathy: a systematic review and meta-analysis.Frontiers in pharmacology · 2024Pooled it
- Efficacy and safety of different immunosuppressive agents in patients with calcineurin inhibitor-dependent primary membranous nephropathy.Frontiers in medicine · 2026Article
- Identification of early predictors of clinical remission in primary membranous nephropathy: aClinical kidney journal · 2025Article
- Clinical evaluation of strengthening spleen and draining dampness in the treatment of idiopathic membranous nephropathy: a retrospective 10-year follow-up study.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Article
- Newer B-cell and plasma-cell targeted treatments for rituximab-resistant patients with membranous nephropathy.Clinical kidney journal · 2025Review
- Spontaneous remission in primary membranous nephropathy: mechanisms, predictive factors, and implications for personalized management.Frontiers in immunology · 2025Review
- Observational study of immunosuppressive treatment patterns and outcomes in primary membranous nephropathy: a multicenter retrospective analysis.BMC nephrology · 2024Observational
- Prospective study of the effect of rituximab on kidney function in membranous nephropathy.Clinical kidney journal · 2024Article
- Ten tips on immunosuppression in primary membranous nephropathy.Clinical kidney journal · 2024Review
- Novel Treatments Paradigms: Membranous Nephropathy.Kidney international reports · 2023Review
- Primary membranous nephropathy: an endless story.Journal of nephrology · 2023Review
- Treatment of membranous nephropathy: Perspectives on current and future therapies.Frontiers in nephrology · 2023Review
- Understanding the podocyte immune responses in proteinuric kidney diseases: from pathogenesis to therapy.Frontiers in immunology · 2023Review
- Review
- Advances in the Management of Primary Membranous Nephropathy and Rituximab-Refractory Membranous Nephropathy.Frontiers in immunology · 2022Review
- B Cells in Primary Membranous Nephropathy: Escape from Immune Tolerance and Implications for Patient Management.International journal of molecular sciences · 2021Review
- Calcineurin Inhibitors in Membranous Nephropathy.Kidney international reports · 2021Article
- An Updated Review of Membranous Nephropathy.Indian journal of nephrologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionKidney Disease: Improving Global Outcomes (KDIGO) 2012 recommends cyclical cyclophosphamide plus glucocorticoids (GC) (modified Ponticelli regimen) or calcineurin inhibitors (CNIs) such as tacrolimus (TAC) or cyclosporine as the first-line agents for the management of primary membranous nephropathy (PMN) that is resistant to antiproteinuric therapy with renin-angiotensin system blockers. However, the long-term outcome of patients treated with CNIs is not known.
methodsWe report the outcomes of 70 patients randomized 1:1 to receive modified Ponticelli regimen or TAC/GC for renin-angiotensin system-resistant PMN who were prospectively followed for 6 years. Patients were followed monthly for 12 months, then quarterly for 12 months, and then every 6 months through the end of 6 years.
resultsAt the end of 6 years, 21 (61.76%) and 9 (28.12%) patients maintained relapse-free remission in modified Ponticelli regimen and TAC/GC groups, respectively (relative risk [RR]: 2.19, 95% confidence interval [CI]: 1.23 to 4.15), and 30 (88.23%) and 17 (53.12%) patients were in remission (including relapses) in modified Ponticelli regimen and TAC/GC groups (RR: 1.66; 95% CI: 1.21 to 2.45), respectively. There was no significant difference in the proportion of patients who had a 40% decline in the estimated glomerular filtration rate (eGFR), death, or end-stage kidney disease between the groups. None of the patients treated with modified Ponticelli regimen reported a solid organ or hematological malignancy.
conclusionsTo conclude, in the long-term, modified Ponticelli regimen is superior to TAC/GC as first-line therapy for the management of antiproteinuric-resistant PMN.
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