Rituxan for glomerulonephritis – pro
You have glomerulonephritis, a condition characterized by inflammation that attacks the glomeruli, the filter in the kidney that produces the urine. A number of types of glomerulonephritis exist, each of which has different causes, outcomes if not treated, and responses to treatments.
Rituximab is an antibody that destroys specific immune cells that are thought to underlie the development of IMN.
Remuzzi and colleagues reported the results from a study in Italy, in which 8 patients with IMN that had not responded to standard therapies were treated with rituximab. They observed that 1 of the 8 patients had essentially a complete response of disease, and 3 others had substantial improvements in their disease, as evidenced by decreased urinary protein losses. When the authors of this study compared the responses of these 8 patients with those of control patients chosen who had similar baseline conditions, but who were not treated with rituximab, they suggested that treatment with rituximab significantly decreased urine protein losses and improved renal function. Several side effects were seen with rituximab, including laryngeal spasm, chills, and skin rash. While these results are very preliminary and need to be repeated by future studies, they suggest the potential for rituximab to be added to the armamentarium of therapeutic options for IMN. A recent review stated that in total there were 13 case reports, three case series and one prospective study; however there are no comparative studies.
Remuzzi G, Chiurchiu C, Abbate M, Brusegan V, Bontempelli M, Ruggenenti P. Rituximab for idiopathic membranous nephropathy. J Am Soc Nephrol. 2002;13:15A. Abstract F-FC068.
M. S. Ahmed and C. F. Wong
Rituximab and nephrotic syndrome: a new therapeutic hope?
Nephrol. Dial. Transplant., January 1, 2008; 23(1): 11 – 17.