Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy
Objective: To compare the efficacy of a steroid-free regimen with steroid-based treatment in managing primary membranous nephropathy (PMN) and investigate the potential benefits of steroid-free regimens in PMN therapy.Methods: This was a single-centre prospective cohort study. A total of 81 patients...
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2024.1286422/full |
| _version_ | 1797311580149383168 |
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| author | Hui-Lin Xing Dong-Hong Ma Jin Li Qing-Yu Xu Li-Ke Ji Qiong-Jie Zhu Yu-Qing Luo Ming-Hao Guo |
| author_facet | Hui-Lin Xing Dong-Hong Ma Jin Li Qing-Yu Xu Li-Ke Ji Qiong-Jie Zhu Yu-Qing Luo Ming-Hao Guo |
| author_sort | Hui-Lin Xing |
| collection | DOAJ |
| description | Objective: To compare the efficacy of a steroid-free regimen with steroid-based treatment in managing primary membranous nephropathy (PMN) and investigate the potential benefits of steroid-free regimens in PMN therapy.Methods: This was a single-centre prospective cohort study. A total of 81 patients were divided into two groups according to their medication regimen: a rituximab (RTX)/tacrolimus (TAC) group (low-dose RTX combined with low-dose TAC group, without steroids, n = 31) and a prednisone (P)/TAC group (P combined with TAC group, n = 61). The changes in 24-h urine protein quantification, levels of blood albumin, blood creatinine, total cholesterol, triglyceride and fasting blood glucose as well as anti-phospholipase A2 receptor antibody titres were observed in both groups before treatment and after 1, 3, 6 and 12 months of treatment. Clinical remission (complete and partial remission), serological remission and recurrence were assessed in both groups after treatment, and the occurrence of adverse reactions was observed.Results: 1) Before treatment, there was no significant difference in baseline values between the two groups (p > 0.05). 2) After 12 months of treatment, the 24-h proteinuria and total cholesterol levels in the RTX/TAC group were significantly lower than those in the P/TAC group (p < 0.05). 3) After 6 months of treatment, the clinical remission rate of the RTX/TAC group was significantly higher than that of the P/TAC group (p < 0.05). After 12 months of treatment, the clinical remission rate of the RTX/TAC group was significantly higher than that of the P/TAC group (p < 0.05). (4) After 3, 6 and 12 months of treatment, serological remission rates in the RTX/TAC group were significantly higher than those in the P/TAC group (p < 0.05). During treatment, the anti-PLA2R antibody titres in the RTX/TAC group remained lower than those in the P/TAC group (p < 0.05).Conclusion: The low-dose RTX combined with low-dose TAC steroid-free regimen induces serological remission in patients with PMN earlier than the classic regimen of P combined with TAC, and there was no significant difference in adverse effects between the two groups. Besides, the long-term clinical remission effect of low-dose RTX combined with low-dose TAC is better than that of P combined with TAC. |
| first_indexed | 2024-03-08T02:02:41Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-08T02:02:41Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj.art-5d17c17477804e7a999ca05864f4a2502024-02-14T04:59:06ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122024-02-011510.3389/fphar.2024.12864221286422Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathyHui-Lin XingDong-Hong MaJin LiQing-Yu XuLi-Ke JiQiong-Jie ZhuYu-Qing LuoMing-Hao GuoObjective: To compare the efficacy of a steroid-free regimen with steroid-based treatment in managing primary membranous nephropathy (PMN) and investigate the potential benefits of steroid-free regimens in PMN therapy.Methods: This was a single-centre prospective cohort study. A total of 81 patients were divided into two groups according to their medication regimen: a rituximab (RTX)/tacrolimus (TAC) group (low-dose RTX combined with low-dose TAC group, without steroids, n = 31) and a prednisone (P)/TAC group (P combined with TAC group, n = 61). The changes in 24-h urine protein quantification, levels of blood albumin, blood creatinine, total cholesterol, triglyceride and fasting blood glucose as well as anti-phospholipase A2 receptor antibody titres were observed in both groups before treatment and after 1, 3, 6 and 12 months of treatment. Clinical remission (complete and partial remission), serological remission and recurrence were assessed in both groups after treatment, and the occurrence of adverse reactions was observed.Results: 1) Before treatment, there was no significant difference in baseline values between the two groups (p > 0.05). 2) After 12 months of treatment, the 24-h proteinuria and total cholesterol levels in the RTX/TAC group were significantly lower than those in the P/TAC group (p < 0.05). 3) After 6 months of treatment, the clinical remission rate of the RTX/TAC group was significantly higher than that of the P/TAC group (p < 0.05). After 12 months of treatment, the clinical remission rate of the RTX/TAC group was significantly higher than that of the P/TAC group (p < 0.05). (4) After 3, 6 and 12 months of treatment, serological remission rates in the RTX/TAC group were significantly higher than those in the P/TAC group (p < 0.05). During treatment, the anti-PLA2R antibody titres in the RTX/TAC group remained lower than those in the P/TAC group (p < 0.05).Conclusion: The low-dose RTX combined with low-dose TAC steroid-free regimen induces serological remission in patients with PMN earlier than the classic regimen of P combined with TAC, and there was no significant difference in adverse effects between the two groups. Besides, the long-term clinical remission effect of low-dose RTX combined with low-dose TAC is better than that of P combined with TAC.https://www.frontiersin.org/articles/10.3389/fphar.2024.1286422/fullrituximabtacrolimusprednisoneprimary membranous nephropathysteroids |
| spellingShingle | Hui-Lin Xing Dong-Hong Ma Jin Li Qing-Yu Xu Li-Ke Ji Qiong-Jie Zhu Yu-Qing Luo Ming-Hao Guo Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy Frontiers in Pharmacology rituximab tacrolimus prednisone primary membranous nephropathy steroids |
| title | Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy |
| title_full | Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy |
| title_fullStr | Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy |
| title_full_unstemmed | Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy |
| title_short | Comparison of the efficacy of steroid-free versus classic steroid-containing regimens in primary membranous nephropathy |
| title_sort | comparison of the efficacy of steroid free versus classic steroid containing regimens in primary membranous nephropathy |
| topic | rituximab tacrolimus prednisone primary membranous nephropathy steroids |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2024.1286422/full |
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