As IgA nephropathy (IgAN) is considered to result in part from autoimmune processes, B-cell depletion using rituximab might be a plausible therapy. However, a small randomized, controlled trial in patients at risk of progressive IgAN reports that this therapy failed to reduce proteinuria over 1 year and was associated with more adverse events per patient.
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References
Wyatt, R. J. & Julian, B. A. IgA nephropathy. N. Engl. J. Med. 368, 2402–2414 (2013).
Suzuki, H. et al. Aberrantly glycosylated IgA1 in IgA nephropathy patients is recognized by IgG antibodies with restricted heterogeneity. J. Clin. Invest. 119, 1668–1677 (2009).
Floege, J. & Feehally, J. Treatment of IgA nephropathy and Henoch-Schonlein nephritis. Nat. Rev. Nephrol. 9, 320–327 (2013).
Lafayette, R. A. et al. A randomized, controlled trial of rituximab in IgA nephropathy with proteinuria and renal dysfunction. J. Am. Soc. Nephrol. http://dx.doi.org/10.1681/ASN.2016060640 (2016).
Cravedi, P., Remuzzi, G. & Ruggenenti, P. Rituximab in primary membranous nephropathy: first-line therapy, why not? Nephron Clin. Pract. 128, 261–269 (2014).
Floege, J. & Feehally, J. The mucosa-kidney axis in IgA nephropathy. Nat. Rev. Nephrol. 12, 147–156 (2016).
Rauen, T. et al. Intensive supportive care plus immunosuppression in IgA nephropathy. N. Engl. J. Med. 373, 2225–2236 (2015).
Hogg, R. J. et al. Randomized controlled trial of mycophenolate mofetil in children, adolescents, and adults with IgA nephropathy. Am. J. Kidney Dis. 66, 783–791 (2015).
Manno, C., Torres, D. D., Rossini, M., Pesce, F. & Schena, F. P. Randomized controlled clinical trial of corticosteroids plus ACE-inhibitors with long-term follow-up in proteinuric IgA nephropathy. Nephrol. Dial. Transplant. 24, 3694–3701 (2009).
Lv, J. et al. Combination therapy of prednisone and ACE inhibitor versus ACE-inhibitor therapy alone in patients with IgA nephropathy: a randomized controlled trial. Am. J. Kidney Dis. 53, 26–32 (2009).
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J.F. has received consultancy fees from Pharmalink, Sweden, and is a principal investigator in an Anthera-sponsored clinical trial in IgA nephropathy.
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Floege, J. Rituximab therapy for IgA nephropathy. Nat Rev Nephrol 13, 138–140 (2017). https://doi.org/10.1038/nrneph.2016.188
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DOI: https://doi.org/10.1038/nrneph.2016.188
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