ArticleGlomerular diseases
Clinical Remission as a Function of Exposure to Cyclophosphamide in Patients with Primary Membranous Nephropathy: A One-Year Cohort Study.
Article in Glomerular diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Primary membranous nephropathy (pMN) is a leading cause of nephrotic syndrome (NS) in adults. Cyclophosphamide (CYC) with glucocorticoids (GCs) is recommended for high and very high-risk patients, but the optimal treatment duration and cumulative dose remain unclear. This study aimed to compare the effectiveness and safety of short-duration (SD) versus long-duration (LD) oral CYC regimens in pMN patients with NS. Methods: We conducted a multicenter retrospective cohort study of 54 adult patients with biopsy-proven pMN treated with oral CYC in the USA and India between 2010 and 2022. Patients received either SD-CYC (≤3 months) or LD-CYC (>3 months). The primary outcome was overall remission (complete or partial) at 12 months. Secondary outcomes included complete remission (CR) rates and adverse events. Analyses were stratified by treatment duration and cumulative CYC dose. Results: Overall remission at 12 months was similar between SD and LD groups (73% vs. 83%, Conclusion: Short-term oral CYC combined with GC may be a safe alternative to LD-CYC regimens for achieving clinical remission in pMN. Although these findings align with recent evidence supporting the efficacy of low-dose CYC in pMN, well-designed clinical trials are still needed for more robust clinical validation.
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