Rituximab in glomerular diseases: a case series and narrative review
Abstract Introduction: The use of Rituximab (RTX) in glomerular diseases (GD) has increased in the past years, although it is still only used in a small fraction of patients. Methods: A single center retrospective study of adult patients with membranous nephropathy (MN), focal segmental glomerulos...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Nefrologia
2021-12-01
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| Series: | Brazilian Journal of Nephrology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005081301&tlng=pt |
| _version_ | 1831702210517401600 |
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| author | Inês Duarte João Oliveira Cristina Outerelo Iolanda Godinho Marta Pereira Paulo Fernandes Sofia Jorge Joana Gameiro |
| author_facet | Inês Duarte João Oliveira Cristina Outerelo Iolanda Godinho Marta Pereira Paulo Fernandes Sofia Jorge Joana Gameiro |
| author_sort | Inês Duarte |
| collection | DOAJ |
| description | Abstract Introduction: The use of Rituximab (RTX) in glomerular diseases (GD) has increased in the past years, although it is still only used in a small fraction of patients. Methods: A single center retrospective study of adult patients with membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), lupus nephritis (LN), and vasculitis treated with RTX as first or second-line therapy was conducted at our center from 2010 to 2020. Results: We identified 19 patients; 36.8% had MN and 25.0% each had FSGS, LN, and vasculitis. RTX was first-line therapy in 26.3% of patients and in 73.7% it was second-line therapy. Mean follow-up time was 7.7 ± 7.2 years. In MN, 2 patients (28.6%) had complete remission (CR), 2 patients (28.6%) had partial remission (PR), and 3 patients (42.9%) had no response (NR). In FSGS, 2 patients (50.0%) presented CR, 1 patient (25.0%) had no response, and 1 patient had renal deterioration. Two patients (50.0%) had a LN class IV with a CR after RTX, 1 patient with LN class IIIC/V had no response, and 1 patient with LN class II had renal deterioration. In vasculitis, 3 patients (75.0%) presented CR and 1 patient had PR. Infusion reactions were present in 2 patients (10.5%) and one patient had multiple infectious complications. Conclusions: The efficacy of RTX in treating different types of immune-mediated GD has been demonstrated with different response rates, but an overall safe profile. In our case series, the results are also encouraging. Longitudinal studies are needed to better understand the effect of RTX in GD. |
| first_indexed | 2024-12-20T15:16:50Z |
| format | Article |
| id | doaj.art-61d48ee1a9564146a842640e0d4ea331 |
| institution | Directory Open Access Journal |
| issn | 2175-8239 |
| language | English |
| last_indexed | 2024-12-20T15:16:50Z |
| publishDate | 2021-12-01 |
| publisher | Sociedade Brasileira de Nefrologia |
| record_format | Article |
| series | Brazilian Journal of Nephrology |
| spelling | doaj.art-61d48ee1a9564146a842640e0d4ea3312022-12-21T19:36:09ZengSociedade Brasileira de NefrologiaBrazilian Journal of Nephrology2175-82392021-12-0110.1590/2175-8239-jbn-2021-0120Rituximab in glomerular diseases: a case series and narrative reviewInês Duartehttps://orcid.org/0000-0003-0101-9961João Oliveirahttps://orcid.org/0000-0001-5097-9630Cristina OutereloIolanda GodinhoMarta PereiraPaulo FernandesSofia JorgeJoana Gameirohttps://orcid.org/0000-0001-6143-461XAbstract Introduction: The use of Rituximab (RTX) in glomerular diseases (GD) has increased in the past years, although it is still only used in a small fraction of patients. Methods: A single center retrospective study of adult patients with membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), lupus nephritis (LN), and vasculitis treated with RTX as first or second-line therapy was conducted at our center from 2010 to 2020. Results: We identified 19 patients; 36.8% had MN and 25.0% each had FSGS, LN, and vasculitis. RTX was first-line therapy in 26.3% of patients and in 73.7% it was second-line therapy. Mean follow-up time was 7.7 ± 7.2 years. In MN, 2 patients (28.6%) had complete remission (CR), 2 patients (28.6%) had partial remission (PR), and 3 patients (42.9%) had no response (NR). In FSGS, 2 patients (50.0%) presented CR, 1 patient (25.0%) had no response, and 1 patient had renal deterioration. Two patients (50.0%) had a LN class IV with a CR after RTX, 1 patient with LN class IIIC/V had no response, and 1 patient with LN class II had renal deterioration. In vasculitis, 3 patients (75.0%) presented CR and 1 patient had PR. Infusion reactions were present in 2 patients (10.5%) and one patient had multiple infectious complications. Conclusions: The efficacy of RTX in treating different types of immune-mediated GD has been demonstrated with different response rates, but an overall safe profile. In our case series, the results are also encouraging. Longitudinal studies are needed to better understand the effect of RTX in GD.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005081301&tlng=ptGlomerulonephritisRituximabImmunosuppressionRemission InductionRecurrence |
| spellingShingle | Inês Duarte João Oliveira Cristina Outerelo Iolanda Godinho Marta Pereira Paulo Fernandes Sofia Jorge Joana Gameiro Rituximab in glomerular diseases: a case series and narrative review Brazilian Journal of Nephrology Glomerulonephritis Rituximab Immunosuppression Remission Induction Recurrence |
| title | Rituximab in glomerular diseases: a case series and narrative review |
| title_full | Rituximab in glomerular diseases: a case series and narrative review |
| title_fullStr | Rituximab in glomerular diseases: a case series and narrative review |
| title_full_unstemmed | Rituximab in glomerular diseases: a case series and narrative review |
| title_short | Rituximab in glomerular diseases: a case series and narrative review |
| title_sort | rituximab in glomerular diseases a case series and narrative review |
| topic | Glomerulonephritis Rituximab Immunosuppression Remission Induction Recurrence |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002021005081301&tlng=pt |
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