Kidney International Reports (Apr 2021)
Rituximab in Membranous Nephropathy
- Philipp Gauckler,
- Jae Il Shin,
- Federico Alberici,
- 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 Kohli,
- Gert 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,
- Philipp Gauckler,
- Jae Il Shin,
- Federico Alberici,
- 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 Kohli,
- Gert 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
Affiliations
- Philipp Gauckler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria; Correspondence: Philipp Gauckler, Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
- Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea; Division of Pediatric Nephrology, Severance Children's Hospital, Seoul, Korea; Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Korea
- Federico Alberici
- Nephrology Unit, ASST Spedali Civili di Brescia, Brescia, Italy; Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Vincent Audard
- Department of Nephrology and Transplantation, Rare French Disease Centre ''Idiopathic Nephrotic syndrome'', Henri-Mondor/Albert-Chenevier Hospital Assistance Publique-Hôpitaux de Paris, Inserm U955, Team 21, Paris-East University, Créteil, France
- Annette Bruchfeld
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Renal Medicine, CLINTEC, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
- Martin Busch
- Department of Internal Medicine III, University Hospital Jena, Friedrich-Schiller-University, Jena, Germany
- Chee Kay Cheung
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; John Walls Renal Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
- Matija Crnogorac
- Department of Nephrology and Dialysis, Dubrava University Hospital, Zagreb, Croatia
- Elisa Delbarba
- Nephrology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
- Kathrin Eller
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Stanislas Faguer
- Département de Néphrologie et Transplantation d'Organes, Centre de Référence des Maladies Rénales Rares, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Institut National de la Santé et de la Recherche Médicale, U1048 (Institut des Maladies Cardiovasculaires et Métaboliques-équipe 12), Toulouse, France
- Kresimir Galesic
- Department of Nephrology and Dialysis, Dubrava University Hospital, Zagreb, Croatia
- Siân Griffin
- Department of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK
- Martijn W.F. van den Hoogen
- Department of Internal Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, Netherlands
- Zdenka Hrušková
- Department of Nephrology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Anushya Jeyabalan
- Division of Nephrology, Columbia University Medical Center, New York, New York, USA
- Alexandre Karras
- Service de Néphrologie, Hôpital Européen-Georges Pompidou, Assistance Publique des Hôpitaux de Paris, Paris, France
- Catherine King
- Department of Renal Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham, Edgbaston, Birmingham, UK
- Harbir Singh Kohli
- Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Gert Mayer
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria
- Rutger Maas
- Department of Nephrology, Radboud University Medical Center, Nijmegen, Netherlands
- Masahiro Muto
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
- Sergey Moiseev
- Tareev Clinic of Internal Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
- Balazs Odler
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Ruth J. Pepper
- University College London Department of Renal Medicine, Royal Free Hospital, London, UK
- Luis F. Quintana
- Department of Nephrology and Renal Transplantation, Hospital Clínic, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), Department of Medicine, University of Barcelona, IDIBAPS, Barcelona, Spain
- Jai Radhakrishnan
- Division of Nephrology, Columbia University Medical Center, New York, New York, USA
- Raja Ramachandran
- Nephrology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
- Alan D. Salama
- University College London Department of Renal Medicine, Royal Free Hospital, London, UK
- Ulf Schönermarck
- Division of Nephrology, Department of Medicine IV, University Hospital, LMU Munich, Munich, Germany
- Mårten Segelmark
- Department of Clinical Sciences Lund, University, Skane University Hospital, Nephrology Lund, Lund, Sweden
- Lee Smith
- The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK
- Vladimír Tesař
- Department of Nephrology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Jack Wetzels
- Department of Nephrology, Radboud University Medical Center, Nijmegen, Netherlands
- Lisa Willcocks
- Department of Renal Medicine, Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
- Martin Windpessl
- Department of Internal Medicine IV, Section of Nephrology, Klinikum Wels-Grieskirchen, Wels, Austria; Medical Faculty, Johannes Kepler University Linz, Linz, Austria
- Ladan Zand
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
- Reza Zonozi
- Division of Nephrology, Vasculitis and Glomerulonephritis Center, Massachusetts General Hospital, Boston, Massachusetts, USA
- Andreas Kronbichler
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria; Andreas Kronbichler, Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
- Philipp Gauckler
- Jae Il Shin
- Federico Alberici
- 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 Kohli
- Gert 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
- Journal volume & issue
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Vol. 6,
no. 4
pp. 881 – 893
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.”
