International Journal of General Medicine (May 2023)

The Safety and Efficacy of Rituximab-Based Regimen in Atypical Membranous Nephropathy: A Single Center Retrospective Cohort Study

  • Liu Y,
  • Zhang S,
  • Hu R,
  • Li C,
  • Chen G,
  • Shi X,
  • Liu Y,
  • Zheng K,
  • Li H,
  • Wen Y,
  • Li X,
  • Li X,
  • Xia P,
  • Qin Y

Journal volume & issue
Vol. Volume 16
pp. 1983 – 1993

Abstract

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Yanan Liu, Shuo Zhang, Rongrong Hu, Chao Li, Gang Chen, Xiaoxiao Shi, Yan Liu, Ke Zheng, Hang Li, Yubing Wen, Xuemei Li, Xuewang Li, Peng Xia, Yan Qin Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaCorrespondence: Peng Xia; Yan Qin, Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China, Tel +86 01069155058, Email [email protected]; [email protected]: There are increasing reports of atypical membranous nephropathy (AMN) cases with similar pathological characteristics to secondary membranous nephropathy (SMN) without definite underlying causes. Although rituximab has become a first-line option in treating idiopathic membranous nephropathy (IMN), the efficacy and safety of rituximab-based regimen for AMN is not clear.Patients and Methods: This is a retrospective, single-center study. AMN patients who received rituximab-based therapy were included. IMN patients treated with rituximab during the same period were selected as the control group matched by gender, sex, baseline urinary protein and albumin levels. Baseline data and follow-up data were collected.Results: A total of 20 AMN patients and 40 IMN patients were included. The baseline levels of urinary protein were comparable between the two groups [6.77 (IQR 3.34, 11.49) g/24 h vs 6.47 (IQR 3.4, 10.76) g/24 h, P=0.944]. The baseline levels of serum albumin were 26.15± 6.71 g/L and 26.8± 5.54 g/L (P=0.689) respectively. The cumulative remission rate for rituximab-based treatment at the 12th month was lower in AMN group than IMN group [13 (65%) vs 36 (90%), P=0.045]. In AMN group, non-responders showed a higher level of proteinuria and a worse renal function at baseline than those of responders. There was no significant difference in the overall adverse events or serious adverse events between the two groups.Conclusion: In our study, AMN patients obtained proteinuria remission in a lower percentage compared with IMN patients. In general, rituximab-based therapy is effective in AMN patients with an acceptable safety profile.Keywords: rituximab, atypical membranous nephropathy, idiopathic membranous nephropathy, efficacy

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