Treatment of fibrillary glomerulonephritis with rituximab: a 12-month pilot study.

Autor:	Erickson SB; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA., Zand L; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA., Nasr SH; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Alexander MP; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Leung N; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA., Drosou ME; Department of Internal Medicine, Lankenau Medical Center, Philadelphia, PA, USA., Fervenza FC; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA.
Jazyk:	angličtina
Zdroj:	Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2021 Jan 01; Vol. 36 (1), pp. 104-110.
DOI:	10.1093/ndt/gfaa065
Abstrakt:	Background: Fibrillary glomerulonephritis (FGN) is a rare type of glomerulonephritis with poor prognosis, with no known effective therapies available for treatment. The objective of the study was to evaluate the efficacy and safety of rituximab in treatment of patients with FGN and to investigate the effect of rituximab on DNAJB9 levels. Methods: This was a pilot prospective clinical trial in which patients with idiopathic FGN were treated with two courses of rituximab (1 g each) 2 weeks apart at the beginning and then again at 6 months. Primary outcome was defined as preservation of kidney function at 12 months with stable or increased creatinine clearance. Secondary outcome was defined as achieving complete remission (CR) defined as proteinuria <300 mg/24 h or partial remission (PR) with proteinuria <3 g/24 h and at least 50% reduction in the proteinuria. DNAJB9 levels were also measured in the serum at baseline, 6 and 12 months. Results: The creatinine clearance did not change significantly during this time, from 47.7 mL/min/1.73 m2 at baseline to 43.7 mL/min/1.73 m2 during follow-up (P = 0.15). Proteinuria declined from 4.43 (1.6-5.53) g/24 h at baseline to 1.9 (0.46-5.26) g/24 h at 12 months but did not reach significance (P = 0.06). None of the patients reached CR, and 3 of the 11 achieved PR. There was no change in the DNAJB9 levels following treatment with rituximab. The most common adverse event was nasal congestion, fatigue and muscle cramps. Conclusions: Treatment of patients with two courses of rituximab over a span of 6 months was associated with stabilization of renal function but did not result in a significant change in proteinuria and with no change in the DNAJB9 levels. (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
Databáze:	MEDLINE
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