Rituximab Immunomonitoring Predicts Remission in Membranous Nephropathy

• DOI: 10.3389/fimmu.2021.738788
• Publication Date: 2021-10-13T18:25:32Z
• Authors: Maxime Teisseyre; Marion Cremoni; Sonia Boyer-Suavet; Thomas Crepin; Sylvia Benzaken; Kévin Zorzi; Vincent Esnault; Vesna Brglez; Barbara Seitz-Polski
• Keywords: Membranous Nephropathy

Primary membranous nephropathy (pMN) is an autoimmune kidney disease and a common cause of nephrotic syndrome in adults. Rituximab becoming first line therapy for patients with persistent proven safety efficacy, achieving remission 60%–80% cases. For the remaining 20%–40% there urgent need to identify early biomarkers resistance rituximab adapt therapeutic management. In patients, found blood more transiently than other diseases without proteinuria, due wasting urine. However, immunomonitoring not routinely performed. We evaluated predictive value serum levels pMN three months after injection (month-3) on clinical rates six (month-6) 12 (month-12) investigated factors at month-3. Sixty-eight treated between July 2015 January 2020 from two French nephrology centers were included. identified residual month-3 as novel predictor month-6 ( p <0.0001) month-12 = 0.001). Reduced likelihood undetectable was associated lower albumin higher anti-PLA2R1 titers baseline albumin, CD19 + counts during follow-up. multivariate analysis, high proteinuria independent risk treatment failure weight month-12. factor Patients below 22.5 g/L had 8.66-fold having Therefore, would allow detection Studies are needed assess whether low may benefit additional course rituximab.