Publication date available at www.cjasn.org.. 15 to 20% rate of total remission and a 35 to 40% rate of partial remission. The drug was well tolerated with minimal adverse events. Conclusions: Although rituximab may prove to be a better treatment option for MN than alkylating providers or calcineurin inhibitors, the current literature only supports using the drug in study protocols. Whether, when, how, and why to use rituximab in MN remains to be identified. Membranous nephropathy (MN) remains a leading cause of nephrotic syndrome in adults (1,2). In most individuals, an underlying etiology for the lesion is definitely unknown and the disorder is definitely termed idiopathic. About one-quarter of instances are felt secondary to a predisposing disease (sponsor disease), two reports on lupus-associated MN, and instances of MN in the establishing of hepatitis and rheumatoid arthritis. The patients in Abarelix Acetate these reports, regardless of diagnosis or previous treatments, had severe proteinuria (mean 10.5 g/24h, interquartile range 8.6 to 13 g/24 h) with preserved renal function (estimated Abarelix Acetate glomerular filtration rates, when reported, were generally greater than 50 ml/min/1.73m2). Abarelix Acetate Table 1. Overview of 21 studies included for reviewa 1) 1)f(2002)8Idiopathic MN with persistent NSFull-dose ACE-I for mean 29.7 mo8.6Cr 1.4 mg/dlRuggenenti (2003)8bIdiopathic MN with persistent NSFull-dose ACE-I for mean 29.7 mo8.6Cr 1.4 mg/dlRatanatharathorn (2003)1Secondary MN after hematopoietic stem cell transplantTacrolimus, methylprednisolone, and MMF over 8 mo15.0Not reportedFra (2003)1Secondary MN in setting of SLE with persistent NSHigh-dose prednisone (cumulative dose 13.7 g) and cyclophosphamide (cumulative dose 15.7 g) over 9 mo2.0Cr 0.8 mg/dlRossi (2005)1Idiopathic MNMethylprednisolone 2 mg/kg/d for 2 wk, then 5 mg/kg/d for 1 wk11.0Normal rangeRao (2005)2Secondary MN after hematopoietic stem cell transplantNone (= 1); prednisone, MMF, and ARB for 3 mo (= 1)9.5Cr 1.1 mg/dlSrinivasan (2005)2Secondary MN after hematopoietic stem cell transplantCyclosporine (= 2) and prednisone (= 1)21.0CrCl 47.9 ml/minJacobson (2006)1Secondary MN in setting of SLE with persistent NSCyclophosphamide, prednisolone, cyclosporine, and MMF over 33 mo5.3Cr 2.7 mg/dlCobo (2006)1Idiopathic MN with persistent NSACE-I + ARB for 8 mo, then steroids and chlorambucil for 5 mo7.3Cr 1.0 mg/dlGallon and Chhabra (2006)1Recurrent idiopathic MN after kidney transplantFull-dose ACE-I for 1 mo on top of maintenance immunosuppression with MMF and tacrolimus16.0Cr 1.8 mg/dlReddy (2006)1Secondary MN after hematopoietic stem cell transplantMethylprednisolone8.0Not reportedRuggenenti (2006)23cIdiopathic MN with persistent NSACE-I for at least 6 mo9.1Cr 1.4 mg/dlTerrier (2007)1Secondary MN after hematopoietic stem cell transplantACE-I, corticosteroids, and MMF8.2CrCl 57 ml/minCravedi (2007)12dIdiopathic MN with persistent NSACE-I for at least 6 mo10.3Cr 1.4 mg/dlPansini (2007)1Secondary MN in setting of HCV with relapse on NSFull-dose ACE-I10.4Cr 0.8 mg/dlFervenza (2008)15Idiopathic MN with persistent NSACE-I + ARB for at least 4 mo (= 15); prednisone alone (= 2); prednisone and alkylating agent (= 2); cyclosporine (= 2); MMF (= 1)13.0Cr 1.4 mg/dlFerrannini (2008)1Secondary MN after hematopoietic stem cell transplantMethylprednisolone 1 g/d for 3 d, then prednisone decreased until 0.5 mg/kg/d35.2Cr 0.9 mg/dlTroxell (2008)4Secondary MN after hematopoietic stem cell transplantPrednisone alone (= 1); prednisone and MMF (= 1)10.3Cr 1.3 mg/dlWeclawiak (2008)1Recurrent idiopathic MN after kidney transplantACE-I for 18 mo, then ACE-I and ARB for 7 mo, in addition to maintenance immunosuppression with prednisone, MMF, and cyclosporine10.8Cr 1.5 mg/dlPixley (2008)1Secondary MN in setting of rheumatoid arthritisPrednisone, chlorambucil, and MMF over 10 mo19.5Not reportedRuggenenti (2008)7eIdiopathic MN with persistent NSACE-I for at least 6 mo5.5Cr 1.0 mg/dl Open in a separate window aACE-I, angiotensin-converting enzyme inhibitor; Rabbit Polyclonal to MCM5 ARB, angiotensin receptor blocker; Cr, serum or plasma creatinine; CrCl, creatinine clearance; HCV, hepatitis C computer virus; MMF, Mycophenolate Mofetil; MN, membranous nephropathy; NS, nephrotic syndrome; SLE, systemic lupus erythematosus. bThe study reported the long-term (12 mo) follow-up of the 8 patients from the earlier Remuzzi (2002) study. cOf the 23.