Rituximab in Membranous Nephropathy.
Rituximab in Membranous Nephropathy.
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DOI：
10.1016/j.ekir.2020.12.035
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发表时间：
2021-04
影响因子：
6
通讯作者：
RITERM study group
中科院分区：
文献类型：
--
作者：
Gauckler P;Shin JI;Alberici F;Audard V;Bruchfeld A;Busch M;Cheung CK;Crnogorac M;Delbarba E;Eller K;Faguer S;Galesic K;Griffin S;van den Hoogen MWF;Hrušková Z;Jeyabalan A;Karras A;King C;Kohli HS;Mayer G;Maas R;Muto M;Moiseev S;Odler B;Pepper RJ;Quintana LF;Radhakrishnan J;Ramachandran R;Salama AD;Schönermarck U;Segelmark M;Smith L;Tesař V;Wetzels J;Willcocks L;Windpessl M;Zand L;Zonozi R;Kronbichler A;RITERM study group
膜性肾病（MN）是成人原发性肾病综合征最常见的原因。磷脂酶A2受体（PLA2R）作为靶抗原在大多数患者中的鉴定极大地改变了MN的管理，并为B细胞耗竭剂如利妥昔单抗提供了理论基础。利妥昔单抗诱导缓解的疗效已在多项研究中进行了研究，包括3项随机对照试验，其中约三分之二的治疗患者实现了蛋白尿的完全和部分缓解。由于其良好的安全性，利妥昔单抗现在被认为是MN的一线治疗选择，特别是在中度和高度肾功能恶化风险的患者中。然而，关于如何最好地使用利妥昔单抗的问题仍然存在，包括最佳给药方案，维持治疗的潜在需求以及长期安全性和有效性结果的评估。在本文中，我们概述了当前文献，并讨论了“新标准”的优点和局限性。
Membranous nephropathy (MN) is the most common cause of primary nephrotic syndrome among adults. The identification of phospholipase A2 receptor (PLA2R) as target antigen in most patients changed the management of MN dramatically, and provided a rationale for B-cell depleting agents such as rituximab. The efficacy of rituximab in inducing remission has been investigated in several studies, including 3 randomized controlled trials, in which complete and partial remission of proteinuria was achieved in approximately two-thirds of treated patients. Due to its favorable safety profile, rituximab is now considered a first-line treatment option for MN, especially in patients at moderate and high risk of deterioration in kidney function. However, questions remain about how to best use rituximab, including the optimal dosing regimen, a potential need for maintenance therapy, and assessment of long-term safety and efficacy outcomes. In this review, we provide an overview of the current literature and discuss both strengths and limitations of “the new standard.”
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影响因子：
4.2
作者：
Cravedi, Paolo;Sghirlanzoni, Maria Chiara;Ruggenenti, Piero
通讯作者：
Ruggenenti, Piero
影响因子：
4.6
作者：
Fiorentino M;Tondolo F;Bruno F;Infante B;Grandaliano G;Gesualdo L;Manno C
通讯作者：
Manno C
影响因子：
1.1
作者：
Busch, Martin;Ruester, Christiane;Wolf, Gunter
通讯作者：
Wolf, Gunter
影响因子：
19.6
作者：
Fervenza, F. C.;Cosio, F. G.;Cattran, D. C.
通讯作者：
Cattran, D. C.
影响因子：
13.2
作者：
Dussol, Bertrand;Morange, Sophie;Berland, Yvon
通讯作者：
Berland, Yvon