ArticleBMC nephrology2023
Monthly mini-dose rituximab for primary anti-PLA2R-positive membranous nephropathy: a personalized approach.
Article in BMC nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- Retrospective study of treatment effectiveness and remission predictors of obinutuzumab in primary membranous nephropathy.BMC nephrology · 2026Article
- Systemic inflammation and B cell indices predict rituximab responses in membranous nephropathy.Clinical kidney journal · 2026Article
- Article
- Efficacy and safety of rituximab for membranous nephropathy in adults: a meta-analysis of RCT.Frontiers in nephrology · 2025Article
- Case Report: Subcutaneous ofatumumab for patients with immunosuppressant-dependent or ineffective primary membranous nephropathy.Frontiers in immunology · 2025Article
- Influencing Factors of Treatment Response to Rituximab in Refractory Membranous Nephropathy.Drug design, development and therapy · 2025Article
- Different Dosage Regimens of Rituximab in Primary Membranous Nephropathy Treatment: A Systematic Review.International journal of nephrology and renovascular disease · 2024Review
- Dosing optimization of rituximab for primary membranous nephropathy by population pharmacokinetic and pharmacodynamic study.Frontiers in pharmacology · 2024Article
- Kinetic-pharmacodynamic model to predict post-rituximab B-cell repletion as a predictor of relapse in pediatric idiopathic nephrotic syndrome.Frontiers in pharmacology · 2024Article
- Overlap of Primary Membranous Nephropathy, IgA Nephropathy, and Diabetic Nephropathy: A Case Report.Cureus · 2023Article
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Abstract
backgroundThe currently recommended dose of rituximab for primary membranous nephropathy is as high as that for lymphoma. However, the clinical manifestations of membranous nephropathy vary widely. Therefore, achieving individualized treatment is a topic that needs to be explored. This study assessed the efficacy of monthly mini-dose rituximab monotherapy in patients with primary membranous nephropathy.
methodsThis retrospective study included 32 patients with primary membranous nephropathy treated at Peking University Third Hospital between March 2019 and January 2023. All patients were anti-phospholipase A2 receptor (PLA2R) antibody-positive and received rituximab 100 mg intravenously monthly for at least 3 months without other immunosuppressive therapy. Rituximab infusions were sustained until either remission of the nephrotic syndrome or a minimum serum anti-PLA2R titer ˂ 2 RU/mL was achieved.
resultsThe baseline parameters included: proteinuria, 8.5 ± 3.6 g/day; serum albumin, 24.8 ± 3.4 g/L; and anti-PLA2R antibody, 160 (20-2659) RU/mL. B-cell depletion was achieved in 87.5% patients after the first dose of rituximab 100 mg and in 100% after the second equivalent dose. The median follow-up was 24 months (range 18-38). Twenty-seven (84%) patients achieved remission, with 11 (34%) patients achieving complete remission by last follow-up. The relapse-free survival from the last infusion was 13.5 months (range 3-27). Patients were stratified into the low-titer (< 150 RU/mL, n = 17) and high-titer groups (≥ 150 RU/mL, n = 15) based on the anti-PLA2R titer. Sex, age, urinary proteins, serum albumin, and estimated glomerular filtration rate at baseline did not differ significantly between the two groups. At 18 months, compared to the low-titer group, the rituximab dose (960 ± 387 vs 694 ± 270 mg, p = 0.030) was higher, while serum albumin (37.0 ± 5.4 vs 41.3 ± 5.4 g/L, p = 0.033) and the complete remission rate (13% vs 53%, p = 0.000) were both lower in the high-titer group.
conclusionsMonthly rituximab 100 mg appeared as a potential effective regimen for treating anti-PLA2R-associated primary membranous nephropathy with a low anti-PLA2R titer. The lower the anti-PLA2R titer, the lower the rituximab dose required to achieve remission.
trial registrationA retrospective study, registered at ChiCTR (ChiCTR2200057381) on March 10, 2022.
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