Journals / Turkish Journal of Medical Sciences / 2021 / Cilt: 51 - Sayı: 6

Rituximab for the treatment of idiopathic membranous nephropathy with nephrotic syndrome: a systematic review and meta-analysis

Pages
2870–2880
Publication Date
2022-11-01
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

The pooled complete response and overall response (OR) rates at 12 months were 13.2% [95% confidence interval (CI), 0.09–0.18] and 60% (95% CI, 0.48–0.72), and those at 24 months were 27.8% (95% CI, 0.22–0.34) and 66% (95% CI, 0.6–0.72), respectively.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/aim: This meta-analysis comprehensively investigated the efficacy and safety of rituximab (RTX) in patients with idiopathic membranous nephropathy (IMN).
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Key Findings & Data:Materials and methods: We searched the MEDLINE, EMBASE and Cochrane Registry of Controlled Trials databases from January 2000 to January 2020.
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Conclusion & Impact:The pooled complete response and overall response (OR) rates at 12 months were 13.2% [95% confidence interval (CI), 0.09–0.18] and 60% (95% CI, 0.48–0.72), and those at 24 months were 27.8% (95% CI, 0.22–0.34) and 66% (95% CI, 0.6–0.72), respectively.
🔬Design:Lab & Field Experiment
📍Scope:2000 Verileri
⚙️Variables:Domain Parameters

Abstract

Background/aim: This meta-analysis comprehensively investigated the efficacy and safety of rituximab (RTX) in patients with idiopathic membranous nephropathy (IMN). Materials and methods: We searched the MEDLINE, EMBASE and Cochrane Registry of Controlled Trials databases from January 2000 to January 2020. Studies evaluating the efficacy and safety of RTX in the treatment of IMN with nephrotic syndrome (NS) were included. Results: Nine studies (total of 357 patients) were included in the meta-analysis. The pooled complete response and overall response (OR) rates at 12 months were 13.2% [95% confidence interval (CI), 0.09–0.18] and 60% (95% CI, 0.48–0.72), and those at 24 months were 27.8% (95% CI, 0.22–0.34) and 66% (95% CI, 0.6–0.72), respectively. The pooled OR rates for the low-, standard-, and high-dose groups were 39.3%, 64%, and 60%, respectively, and those for the first-line and second-line groups were 58% and 54%, respectively. Conclusion: Treatment of IMN with RTX has comparable efficacy to other immunosuppressive treatments (ISTs). RTX has the advantages of no requirement for steroids and lower rates adverse event and relapse rates. Patients who relapse or are resistant to other IST agents also respond to RTX. RTX-based regimens and other B-cell-targeted therapies may represent the future of IMN therapy.Key words: Rituximab, membranous nephropathy, immunosuppressive treatment, meta-analysis

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Cite This Article

YOU, L., YE, P., XIAO, G., LIANG, J., KONG, Y. (2022). Rituximab for the treatment of idiopathic membranous nephropathy with nephrotic syndrome: a systematic review and meta-analysis. Turkish Journal of Medical Sciences, Cilt: 51 - Sayı: 6, 2870–2880. https://ajindex.com/articles/609469

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References (11)

  1. Couser WG. Primary Membranous Nephropathy. Clinical Journal of the American Society of Nephrology 2017
  2. 12 (6):983-997. doi:10.2215/CJN.11761116 2. Schieppati A, Mosconi L, Perna A, Mecca G, Bertani T et al. Prognosis of untreated patients with idiopathic membranous nephropathy. New England Journal of Medicine 1993
  3. 329 (2):85-89. doi:10.1056/NEJM199307083290203 3. Tomas NM, Beck LJ, Meyer-Schwesinger C, Seitz-Polski B, Ma H et al. Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy. New England Journal of Medicine 2014
  4. 371(24):2277-2287. doi:10.1056/ NEJMoa1409354 4. Beck LJ, Bonegio RG, Lambeau G, Beck DM, Powell DW et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. New England Journal of Medicine 2009
  5. 361 (1):11-21. doi:10.1056/NEJMoa0810457 5. Ponticelli C, Altieri P, Scolari F, Passerini P, Roccatello D et al. A randomized study comparing methylprednisolone plus chlorambucil versus methylprednisolone plus cyclophosphamide in idiopathic membranous nephropathy. Journal of the American Society of Nephrology 1998
  6. 9(3):444- 450. doi:10.1681/ASN.V93444 6. Cybulsky AV, Walsh M, Knoll G, Hladunewich M, Bargman J et al. Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of glomerulonephritis in adults. American Journal of Kidney Diseases 2014
  7. 63(3):363-377. doi:10.1053/j. ajkd.2013.12.001 7. Howman A, Chapman TL, Langdon MM, Ferguson C, Adu D et al. Immunosuppression for progressive membranous nephropathy: a UK randomised controlled trial. The Lancet 2013
  8. 381(9868):744-751. doi:10.1016/S0140-6736(12)61566-9 8. Angioi A, Lepori N, Lopez AC, Sethi S, Fervenza FC et al. Treatment of primary membranous nephropathy: where are we now? Journal of Nephrology 2018
  9. 31(4):489-502. doi:10.1007/ s40620-017-0427-5 9. Salles G, Barrett M, Foa R, Maurer J, O’Brien S et al. Rituximab in B-Cell Hematologic Malignancies: A Review of 20 Years of Clinical Experience. Advances in Therapy 2017
  10. 34(10):2232- 2273. doi:10.1007/s12325-017-0612-x 10. Ruggenenti P, Fervenza FC, Remuzzi G. Treatment of membranous nephropathy: time for a paradigm shift. Nature Reviews Nephrology 2017
  11. 13(9): 563-579. doi:10.1038/ nrneph.2017.92 11. Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_e