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Rituximab therapy for Type I membranoproliferative glomerulonephritis.
MedLine Citation:
PMID:  22445472     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aims: Type I membranoproliferative glomerulonephritis (MPGN) is an immune-complex disease with a relatively poor prognosis. It has no established treatment in adults. Our hypothesis was that this disease would respond to B cell depletion with rituximab, an anti-CD20 monoclonal antibody. Methods: We conducted an openlabel trial, in Canada and the United States, of rituximab in 6 adult patients with Type I MPGN (4 idiopathic, 2 with cryoglobulinemia). The rituximab dose was 1,000 mg intravenously on Day 1 and on Day 15. The patients were followed for 1 year. The primary outcome was the change in proteinuria. Results: Peripheral blood B cells were suppressed, after rituximab, in all patients. The mean urinary protein excretion was 3.9 ± 2.0 g/d before treatment. Proteinuria fell in all patients, at all-time points, after rituximab administration. The difference was statistically significant (p < 0.05) at 6, 9 and 12 months, but not at 3 months. The minimum mean urinary protein excretion was 1.4 ± 1.4 g/d at 9 months. There were 2 complete and 3 partial remissions among the 6 patients. The creatinine clearance did not change significantly over the course of the study. There were no adverse effects. Conclusions: Rituximab reduced proteinuria among patients with Type I MPGN. This trial suggests that B cells may play a role in this disease and that additional study of B-cell suppression is warranted.
Authors:
John J Dillon; Michelle Hladunewich; William E Haley; Heather N Reich; Daniel C Cattran; Fernando C Fervenza
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  77     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  290-5     Citation Subset:  IM    
Affiliation:
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA, Toronto Glomerulonephritis Registry, University of Toronto, Toronto, Ontario, Canada and Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL, USA.
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