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Rituximab in glomerular diseases: a case series and narrative review

Authors :
Inês Duarte
João Oliveira
Cristina Outerelo
Iolanda Godinho
Marta Pereira
Paulo Fernandes
Sofia Jorge
Joana Gameiro
Source :
Brazilian Journal of Nephrology (2021)
Publication Year :
2021
Publisher :
Sociedade Brasileira de Nefrologia, 2021.

Abstract

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.

Details

Language :
English, Portuguese
ISSN :
21758239
Database :
Directory of Open Access Journals
Journal :
Brazilian Journal of Nephrology
Publication Type :
Academic Journal
Accession number :
edsdoj.61d48ee1a9564146a842640e0d4ea331
Document Type :
article
Full Text :
https://doi.org/10.1590/2175-8239-jbn-2021-0120