Rituximab treatment of idiopathic membranous nephropathy

F. C. Fervenza, F. G. Cosio, S. B. Erickson, U. Specks, A. M. Herzenberg, J. J. Dillon, N. Leung, I. M. Cohen, D. N. Wochos, E. Bergstralh, M. Hladunewich, D. C. Cattran

Research output: Contribution to journalArticle

170 Scopus citations

Abstract

Idiopathic membranous nephropathy is a common cause of nephrotic syndrome whose pathogenesis may involve B-cell functions. Rituximab is a monoclonal antibody that binds to the CD20 antigen on B cells thereby deleting them. We conducted an open-label pilot trial of rituximab treatment in 15 severely nephrotic patients with proteinuria refractory to angiotensin-converting enzyme inhibition and/or receptor blockade but with adequately controlled blood pressure. Rituximab was given 2 weeks apart and, at 6 months, patients who remained proteinuric but had recovered B-cell counts were given a second course of treatment. Proteinuria was significantly decreased by about half at 12 months. Of the 14 patients who completed follow-up, full remission was achieved in two and partial remission in six patients based upon the degree of proteinuria. Side effects were minor; however, we found no relationship between the response and number of B cells in the blood, CD20 cells in the kidney biopsy, degree of tubulointerstitial fibrosis, starting proteinuria or creatinine values. Rituximab appears effective in reducing proteinuria in some patients with idiopathic membranous nephropathy but prospective identification of responsive patients was not possible.

Original languageEnglish (US)
Pages (from-to)117-125
Number of pages9
JournalKidney international
Volume73
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Membranous nephropathy
  • Nephrotic syndrome
  • Pharmacodynamics, HACA
  • Pharmacokinetics
  • Rituximab

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Fervenza, F. C., Cosio, F. G., Erickson, S. B., Specks, U., Herzenberg, A. M., Dillon, J. J., Leung, N., Cohen, I. M., Wochos, D. N., Bergstralh, E., Hladunewich, M., & Cattran, D. C. (2008). Rituximab treatment of idiopathic membranous nephropathy. Kidney international, 73(1), 117-125. https://doi.org/10.1038/sj.ki.5002628