Rituximab may be effective in treating membranous nephropathy

Current treatments for membranous nephropathy are limited to steroids, calcineurin inhibitors, and chemotherapeutic agents, all of which have significant side effects.

Findings appearing in the April 2009 print issue of the Clinical Journal of the American Society of Nephrology (CJASN) indicate that rituximab may be effective in treating this kidney disorder.

To investigate rituximab's potential, Andrew Bomback, MD (University of North Carolina Kidney Center), and his colleagues conducted the first systematic review of rituximab use in patients with membranous nephropathy. They collected and analyzed all of the data available on rituximab therapy in this patient population. They found 21 articles to date, all of which were either case reports or case series without controls, meaning that patients taking rituximab were studied for a certain length of time but were not compared with patients not taking the drug.

The available data suggest that current rituximab dosing achieves a 15% to 20% rate of complete remission and a 35% to 40% rate of partial remission: rates similar to the response rates of current treatments. Importantly, rituximab appears to be well-tolerated with minimal short-term side effects.

Rituximab may have potential for treating membranous nephropathy, but additional studies - in particular, randomized controlled clinical trials - are needed to prove the drug's value. "Our conclusion is that, at present, rituximab should only be used in research settings," said Dr. Bomback.

The authors reported no financial disclosures.

The article, entitled 'Rituximab Therapy for Membranous Nephropathy: A Systematic Review,' will appear online at http://cjasn.asnjournals.org/ on Wednesday, March 11, 2009, doi 10.2215/CJN.05231008.

Founded in 1966, the American Society of Nephrology (ASN) is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

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