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Kidney Week

Abstract: PO1648

Evaluating the Efficacy of Rituximab in Primary Membranous Nephropathy: An Observational Study from Southern India

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Saigal, Megha, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
  • Guditi, Swarnalatha, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
Background

Membranous nephropathy, is an immunological disease. It can occur secondary to infection, malignancy, or SLE. In 70% of patients M-type phospholipase A2 receptor (PLA2R) was positive, and these patients are considered to suffer from primaryMN.
In primary MN immunosuppressive therapy is started in patients with progressive disease activity.There have been several studies comparing the efficacy of different immunosuppressive regimens, however the role of rituximab as a primary/ secondary immunosupressive agent in primary MN has not been evaluated among Indian population

Methods

Single centre observational pilot study 20 subjects with histological/ serum Pla2r positive progressive primary membranous nephropathy were recruited. They were then either started on conventional immunosupressve therapy (modified ponticelli regimen) and if no or partial response were initiated on rituximab as a second line agent or in some cases as a primary immunosupressive agent. Rituximab was started as375mg/m2 a 4weekly doses .Data regarding urine protein creatinine ratio, serum albumin, serum creatinine, CD 19 count, time to achieve to remission and side-effects were noted.

Results

In our study, males were 65% (13), females contribute to 35% (7). After rituximab therapy 75% (15/20) achieved remission, significant changes were seen in the form of decrease in proteinurea and increase in serum protein and serum albumin levels p value <0.05. Time to achieve remission & median no. of doses required was 1.66 + 0.81 months and 3 respectively. 85% sustained remission attained,with mean duration of followup being 10.16 + 5.96 months. .

Conclusion

Therapy with rituximab as a primary/ secondary immunosupressive agent was effective in inducing and maintaining remission in a significant proportion of patients with primary MN.

Results