Efficacy of Rituximab Combined With Cyclosporine in the Treatment of Idiopathic Membranous Nephropathy
Idiopathic Membranous Nephropathy
About this trial
This is an interventional treatment trial for Idiopathic Membranous Nephropathy
Eligibility Criteria
Inclusion Criteria: age 18-70 years; serum albumin level <30 g/L; estimated glomerular filtration rate (eGFR according to the CKD-EPI formula) ≥60 mL/min per 1.73 m2; patients with a moderate risk of IMN and decline <50% in proteinuria despite blockade of the renin-angiotensin system 3 months before randomization; patients at high risk or very high risk of IMN. Exclusion Criteria: secondary causes of MN; being pregnant or breastfeeding; uncontrollable active infectious disease; immunosuppressive treatment in the preceding 3 months.
Sites / Locations
- Beijing Friendship Hospital, Capital Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Rituximab
Modified Ponticelli regimen
Patients received rituximab 100 and 500 mg of intravenous medication on days 1 and 2, respectively. If proteinuria was reduced from baseline by no more than 25% at 3 months, cyclosporine was administered. In addition, CD19+ B-cell count was monitored every 3 months, and another rituximab 100 and 500 mg will be administered if CD19+ B-cell count >5 cells/mL.
Patients received corticosteroids at months 1, 3, and 5 (methylprednisolone 0.5 g at days 1, 2, and 3, then prednisone 0.5 mg/kg/d from day-4 to day-30). At months 2, 4, and 6, patients received cyclophosphamide adjusted for age and renal function (1.0-2.0 mg/kg/day for 30 days, maximum dose 100 mg/d).