Source: Thailand Medical News Jul 18, 2019 6 years, 7 months, 2 weeks, 1 day, 10 hours, 24 minutes ago
A recent clinical study by Mayo Clinic in collaboration with Genetech, showed that Rituximab was just as effective at treating patients with membranous nephropathy at high risk for progressive disease, when compared with current conventional protocols which in most cases involves cyclosporine.
Rituximab demonstrated in inducing complete or partial remission of proteinuria at 12 months and is superior in maintaining proteinuria remission up to 24 months.
In the clinical study, 130 patients with membranous nephropathy were randomly assigned to receive either intravenous rituximab or oral cyclosporine.
The patients in the study were followed for 24 months, and had prior proteinuria of at least 5 g per 24 hours and a quantified creatinine clearance of at least 40 mL per minute per 1.73 m² of body surface area and had been receiving angiotensin-system blockade for at least 90 days.
The team from Mayo Clinic found that at 365 days, 39 of 65 patients (60 percent) in the rituximab group and 34 of 65 (52 percent) in the cyclosporine group had complete or partial remission (risk difference, 8 percentage points; 95 percent confidence interval, −9 to 25; P = 0.004 for noninferiority). At 730 days, 39 patients (60 percent) in the rituximab group and 13 patients (20 percent) in the cyclosporine group had complete or partial remission (risk difference, 40 percentage points; 95 percent confidence interval, 25 to 55; P < 0.001 for both noninferiority and superiority). Among patients in remission who tested positive for anti-phospholipase A2 receptor (PLA2R) antibodies, the decline in autoantibodies to anti-PLA2R was faster and of greater magnitude and duration in the rituximab group than in the cyclosporine group.
Dr Fernando C. Fervenza, Ph.D, lead author commented in a phone interview with Thailand Medical News,"We found that rituximab was noninferior to cyclosporine in inducing proteinuria remission at 365 days and was superior in maintaining long-term proteinuria remission up to 730 days in patients with membranous nephropathy who were at high risk for progressive disease."
