B cell suppression in primary glomerular disease.
Adv Chronic Kidney Dis
; 21(2): 166-81, 2014 Mar.
Article
in En
| MEDLINE
| ID: mdl-24602466
ABSTRACT
Membranous nephropathy, focal segmental glomerulosclerosis (FSGS), and minimal change disease (MCD) are the most common causes of idiopathic nephrotic syndrome. For many years prednisone, alkylating agents, and calcineurin inhibitors have been the standard of therapy for these patients. More effective or better tolerated treatment modalities are needed. B cell targeted therapy was recently introduced in clinical practice. In this review, we briefly summarize the current standard therapy and discuss the efficacy of B cell targeted therapy in primary glomerular diseases. Observational, short-term studies suggest that rituximab is effective and comparable to standard therapy in maintaining remissions in patients with frequently relapsing or steroid-dependent MCD or FSGS. In contrast, response is limited in patients with steroid-resistant nephrotic syndrome. Rituximab also induces remissions in patients with membranous nephropathy. Controlled clinical trials on kidney endpoints are urgently needed to position B cell targeted therapy in clinical practice.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
B-Lymphocytes
/
Glomerulosclerosis, Focal Segmental
/
Glomerulonephritis, Membranous
/
Immunosuppressive Agents
/
Nephrosis, Lipoid
Limits:
Humans
Language:
En
Journal:
Adv Chronic Kidney Dis
Journal subject:
NEFROLOGIA
Year:
2014
Document type:
Article