Frontiers in Medicine (May 2021)
Rituximab Therapy for Primary Membranous Nephropathy in a Chinese Cohort
- Shuang Gao,
- Shuang Gao,
- Shuang Gao,
- Shuang Gao,
- Zhao Cui,
- Zhao Cui,
- Zhao Cui,
- Zhao Cui,
- Xin Wang,
- Xin Wang,
- Xin Wang,
- Xin Wang,
- Yi-miao Zhang,
- Yi-miao Zhang,
- Yi-miao Zhang,
- Yi-miao Zhang,
- Fang Wang,
- Fang Wang,
- Fang Wang,
- Fang Wang,
- Xu-yang Cheng,
- Xu-yang Cheng,
- Xu-yang Cheng,
- Xu-yang Cheng,
- Li-qiang Meng,
- Li-qiang Meng,
- Li-qiang Meng,
- Li-qiang Meng,
- Fu-de Zhou,
- Fu-de Zhou,
- Fu-de Zhou,
- Fu-de Zhou,
- Gang Liu,
- Gang Liu,
- Gang Liu,
- Gang Liu,
- Ming-hui Zhao,
- Ming-hui Zhao,
- Ming-hui Zhao,
- Ming-hui Zhao,
- Ming-hui Zhao
Affiliations
- Shuang Gao
- Renal Division, Peking University First Hospital, Beijing, China
- Shuang Gao
- Institute of Nephrology, Peking University, Beijing, China
- Shuang Gao
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Shuang Gao
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Zhao Cui
- Renal Division, Peking University First Hospital, Beijing, China
- Zhao Cui
- Institute of Nephrology, Peking University, Beijing, China
- Zhao Cui
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Zhao Cui
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Xin Wang
- Renal Division, Peking University First Hospital, Beijing, China
- Xin Wang
- Institute of Nephrology, Peking University, Beijing, China
- Xin Wang
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Xin Wang
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Yi-miao Zhang
- Renal Division, Peking University First Hospital, Beijing, China
- Yi-miao Zhang
- Institute of Nephrology, Peking University, Beijing, China
- Yi-miao Zhang
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Yi-miao Zhang
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Fang Wang
- Renal Division, Peking University First Hospital, Beijing, China
- Fang Wang
- Institute of Nephrology, Peking University, Beijing, China
- Fang Wang
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Fang Wang
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Xu-yang Cheng
- Renal Division, Peking University First Hospital, Beijing, China
- Xu-yang Cheng
- Institute of Nephrology, Peking University, Beijing, China
- Xu-yang Cheng
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Xu-yang Cheng
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Li-qiang Meng
- Renal Division, Peking University First Hospital, Beijing, China
- Li-qiang Meng
- Institute of Nephrology, Peking University, Beijing, China
- Li-qiang Meng
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Li-qiang Meng
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Fu-de Zhou
- Renal Division, Peking University First Hospital, Beijing, China
- Fu-de Zhou
- Institute of Nephrology, Peking University, Beijing, China
- Fu-de Zhou
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Fu-de Zhou
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Gang Liu
- Renal Division, Peking University First Hospital, Beijing, China
- Gang Liu
- Institute of Nephrology, Peking University, Beijing, China
- Gang Liu
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Gang Liu
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Ming-hui Zhao
- Renal Division, Peking University First Hospital, Beijing, China
- Ming-hui Zhao
- Institute of Nephrology, Peking University, Beijing, China
- Ming-hui Zhao
- Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China
- Ming-hui Zhao
- Key Laboratory of Chronic Kidney Disease (CKD) Prevention and Treatment, Ministry of Education of China, Beijing, China
- Ming-hui Zhao
- Peking-Tsinghua Center for Life Sciences, Beijing, China
- DOI
- https://doi.org/10.3389/fmed.2021.663680
- Journal volume & issue
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Vol. 8
Abstract
Background: Rituximab has become one of the first-line therapies for the treatment of moderate and high-risk primary membranous nephropathy (pMN). We retrospectively reviewed 95 patients with pMN who received rituximab therapy and focused on the therapeutic effects and safety of this therapy in a Chinese cohort.Methods: Ninety-five consecutive patients with pMN diagnosed by kidney biopsy received rituximab and were followed up for >6 months. Four weekly doses of rituximab (375 mg/m2) was adopted as the initial administration. Repeated single infusions were administrated to maintain B cell depletion levels of <5 cells/mL.Results: A total of 91 patients completed rituximab therapy with the total dose of 2.4 (2.0, 3.0) g; 64/78 (82.1%) patients achieved anti-PLA2R antibody depletion in 6.0 (1.0, 12.0) months; 53/91 (58.2%) patients achieved clinical remission in 12.0 (6.0, 24.0) months, including complete remission in 18.7% of patients and partial remission in 39.6% of patients. Multivariate logistic regression analysis showed that severe proteinuria (OR = 1.22, P = 0.006) and the persistent positivity of anti-PLA2R antibodies (OR = 9.00, P = 0.002) were independent risk factors for no-remission. The remission rate of rituximab as an initial therapy was higher than rituximab as an alternative therapy (73.1 vs. 52.3%, P = 0.038). Lastly, 45 adverse events occurred in 37 patients, but only one patient withdrew from treatment due to severe pulmonary infection.Conclusion: Rituximab is a safe and effective treatment option for Chinese patients with pMN, especially as an initial therapy.
Keywords
- primary membranous nephropathy
- CD20 monoclonal antibody
- rituximab
- anti-PLA2R antibody
- first line treatment