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Lancet. 2002 Sep 21;360(9337):923-4.

Rituximab for idiopathic membranous nephropathy.

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Ospedali Riuniti Di Bergam, Unit of Nephrology and Dialysis, Aldo and Cele Daccò Clinical Research Centre for Diseases, Mario Negri Institute for Parmacological Research, Via Gavazzeni 1124125, Bergamo, Italy.

Erratum in

  • Lancet 2002 Dec 21-28;360(9350):2090.


Treatments for idiopathic membranous nephropathy, a common cause of nephrotic syndrome, can be very toxic. In view of the pathogenic potential of B cells in this disease, we studied the effects of four weekly infusions of rituximab (375 mg/m(2)-- the monoclonal antibody to B-cell antigen CD20--in eight patients who had idiopathic membranous nephropathy with persistent nephrotic syndrome. At weeks 4 and 20, urinary protein decreased from mean (SE) 8.6 g/24 h (1.4) to 3.8 (0.8) and 3.7 (0.9), respectively (p<0.0001). At week 20, albuminuria and albumin fractional clearance decreased by 70% and 65%, and serum albumin increased by 31%. CD20 B lymphocytes fell below normal ranges up to study end. The short-term risk-benefit profile of rituximab seems more favourable to that of any other immunosuppressive drug used to treat idiopathic membranous nephropathy.

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