Rituximab may decrease proteinuria in patients who have idiopathic membranous nephropathy (IMN) and severe nephrotic syndrome, according to investigators.


Fernando Fervenza, MD, of the Mayo Clinic in Rochester, Minn., and his colleagues tested the treatment in an open-label pilot trial that enrolled 15 severely nephrotic patients. All patients had proteinuria refractory to ACE inhibitor and angiotensin receptor blocker therapy, but had adequately controlled BP. Proteinuria decreased by about half at 12 months, the researchers reported in Kidney International (2008;73:117-125).

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Of the 14 patients who completed one year of follow-up, full remission was achieved in two and

partial remission achieved in six. Renal function remained stable in most patients. Reported side effects were minor and infusion related.


“This is the largest study to date to prospectively evaluate the effect of rituximab in patients with IMN,” the authors wrote. “In this study, rituximab appears to be effective in reducing proteinuria in a significant number of patients with IMN with severe nephrotic syndrome and relatively well-preserved renal function.”