Linchuang shenzangbing zazhi (Jan 2024)
Therapeutic advances of rituximab alone or plus other drugs for membranous nephropathy
Abstract
Membranous nephropathy (MN) is a common pathological type of adult nephrotic syndrome. According to the etiology, MN is divided into idiopathic membranous nephropathy (IMN) and secondary membranous nephropathy (SMN). IMN accounts for around 80% of MN patients. Glucocorticoid plus alkylating agents or calcineurin inhibitors (CNIs) are frequently prescribed. However, carcinogenic risk of alkylating agents and a high recurrence of disease after the dosing of CNIs have limited the applications of these two types of drugs. In the pathogenesis of MN, B cells play an important role of acting as antigen presenting cells. Rituximab (RTX), a novel immunosuppressive agent, is a monoclonal antibody specific to B cell surface antigen CD20. In many recent clinical studies, RTX alone or plus other drugs has demonstrated a definite efficacy for MN. Whether or not patients benefit more from a single drug or a combination therapy is yet to be determined.
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