ArticleFrontiers in medicine2026
Combination of B-cell-guided rituximab and low-dose tacrolimus for primary membranous nephropathy: a retrospective cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Model-Informed Precision Dosing of Tacrolimus Initial Dosage Optimization in Membranous Nephropathy Patients.Drug design, development and therapy · 2026Article
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9 authors.
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Abstract
Background: B-cell-targeted therapy with rituximab (RTX) has become a first-line option for primary membranous nephropathy (PMN), but current regimens incur substantial medical costs, and some patients show suboptimal responses. The combination of RTX with immunosuppressants has garnered increasing interest, yet its efficacy and optimal dosing remain unclear. This study compared the efficacy and safety of B-cell-guided RTX combined with low-dose tacrolimus (TAC) versus standard RTX monotherapy for the treatment of PMN. Methods: This retrospective analysis included 116 patients diagnosed with PMN between December 2022 and December 2024. All participants were diagnosed based on clinical evaluation and renal biopsy pathology. Of these patients, 57 finally received B-cell-guided RTX combined with low-dose TAC (observation group), while 38 received RTX monotherapy (standard group). In the observation group, RTX dosage was adjusted based on B-lymphocyte counts until B-cell depletion was achieved, accompanied by long-term oral low-dose TAC (0.02 mg/kg/day). Follow-up was conducted monthly after treatment to monitor peripheral blood lymphocyte subsets. RTX was re-administered if CD19+ B-lymphocytes rebounded to >5 cells/μL and the patient had not achieved complete remission. The standard group received two 1 g doses of administered 2 weeks apart. Over a 6-months follow-up, remission rates, incidence of adverse events, and treatment costs were compared between the two regimens. Results: The overall remission rate in the observation group was 71.93%, with complete and partial remission rates of 31.58% and 40.35%, respectively. In the standard group, the overall remission rate was 68.42%, with complete and partial remission rates of 26.32% and 42.1%, respectively; none of these differences were statistically significant ( Conclusion: B-cell-guided RTX combined with low-dose TAC effectively induces clinical remission in patients with PMN, with a lower total RTX dose, improved safety profile, and better cost-effectiveness.
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