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The following is a summary of “Comparations of efficacy and safety of rituximab, calcineurin inhibitors and cyclophosphamide in primary membranous nephropathy: a single-center retrospective analysis,” published in the December 2024 issue of Nephrology by Lu et al.
Researchers conducted a retrospective study to compare the efficacy and safety of rituximab (RTX), calcineurin inhibitors (CNI), and cyclophosphamide (CTX) plus glucocorticoids in treating primary membranous nephropathy (PMN).
They included 478 biopsy-proven patients with PMN from a single center in a retrospective analysis. Following 1:1 propensity score matching (PSM), 258 patients were divided into the RTX, CNI, or CTX group, with 86 patients in each.
The results showed no differences in serum creatinine, eGFR, serum albumin, urine protein, or anti-PLA2R antibody levels among the groups after PSM. The follow-up durations were 12 (10.5, 18) months for the CNI, 12 (12, 18) months for the CTX, and 12 (12, 18) months for the RTX group. Total remission (TR) rates were 39 (45.3%) in the CNI group, 47 (54.7%) in the CTX group, and 59 (68.6%) in the RTX group. The TR rate was higher in the RTX group compared to the CNI group (P = 0.018). Relapse occurred in 15 of 39 (38.5%) patients in the CNI group, significantly higher than in the CTX (4.3%, P < 0.001) and RTX (3.4%, P < 0.001) groups. In the CNI group, 36% of patients experienced a ≥25% decline in eGFR.
They found RTX more effective than CNI in inducing remission in PMN, with similar efficacy to CTX, while CNI had a higher risk of relapse and eGFR decline.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03912-4
