Two-thirds of patients achieve remission and improved or stabilized renal function
FRIDAY, July 27 (HealthDay News) -- For patients with idiopathic membranous nephropathy (IMN) and persistent nephrotic syndrome, rituximab treatment is associated with good rates of partial or complete remission with stabilized or improved renal function, according to a study published online July 19 in the Journal of the American Society of Nephrology.
Piero Ruggenenti, M.D., of the Clinical Research Center for Rare Diseases in Ranica, Italy, and colleagues treated 100 consecutive IMN patients with persistent nephrotic syndrome with rituximab (375 mg/m²).
During a median of 29 months of follow-up after rituximab administration, the researchers found that 65 patients achieved partial or complete remission, regardless of previous immunosuppressive treatment, with a median time to remission of 7.1 months. Partial or complete remission was achieved by all patients who were followed up for at least four years. Those who achieved complete remission had a mean increase in the measured glomerular filtration rate (GFR) of 13.2 mL/min/1.73 m². Patients who achieved a partial or complete remission exhibited significantly increased serum albumin and decreased albumin fractional clearance rates. Proteinuria decline correlated with proteinuria at baseline and the duration of follow-up, with the magnitude of proteinuria reduction correlating with slower GFR decline. There were no treatment-related adverse events.
"In summary, B lymphocyte depletion by rituximab treatment achieved disease remission and stabilized or even improved renal function in a large cohort of IMN patients at high risk of poor outcomes because of persistent nephrotic syndrome, and was remarkably safe," the authors write.
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