Logo-jnp
J Nephropathol. 2018;7(1): 7-10.
doi: 10.15171/jnp.2018.03

Scopus ID: 85041132636
  Abstract View: 4082
  PDF Download: 1950

Short-Review

Is it the time to offer rituximab as a cost-benefit treatment for immunoglobulin A nephropathy? A short-review to current concepts

Mohammad-Reza Tamadon 1, Jamileh Moghimi 2*, Hamed Rezaei 3

1 Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
2 Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
3 General Practitioner, Semnan University of Medical Sciences, Semnan, Iran
*Corresponding Author: *Corresponding author: Jamileh Moghimi, , Email: moghimi_jam@yahoo.com

Abstract

Context: IgA nephropathy (IgAN) as an autoimmune disease is the most common cause of glomerulonephritis worldwide. Rituximab effectively depletes B cells and reduces serum levels of IgA1 antibodies. This paper aimed to review the potential benefit of rituximab used in clinical practice of IgAN patients.

Evidence Acquisitions: PubMed, EBSCO, Web of Science, directory of open access journals (DOAJ), EMBASE, and Google Scholar were searched for the keywords of IgA nephropathy, rituximab, B cell depletion and autoimmune diseases.

Results: Rituximab therapy improved in nephropathies and in recurrent IgAN in several studies. The mechanisms of rituximab therapy in IgAN are unknown. However, a direct effect of rituximab on podocytes by cytoskeleton stabilization is possible. Additionally a possible effect of rituximab on B cells in IgAN may lead to its beneficial impact.

Conclusions: This short-review demonstrates that rituximab therapy may be an effective treatment option in IgAN patients, particularly for histological signs of active inflammation. However, results of safety and efficacy of rituximab in IgAN are limited, and definitive conclusions will require further studies. Thus, multicenter clinical trials for safety and efficacy of rituximab therapy are necessary.


Implication for health policy/practice/research/medical education:

Several recently randomized clinical trials underline the substantial risk of side effects and the lack of proven efficacy with all kinds of immunosuppressive treatment including rituximab. In concordance, other studies observed a reduction of hematuria after RTX therapy.

Please cite this paper as: Tamadon MR, Moghimi J, Rezaei H. Is it the time to offer rituximab as a cost-benefit treatment for immunoglobulin A nephropathy? A short-review to current concepts. J Nephropathol. 2018;7(1):7-10. DOI: 10.15171/ jnp.2018.03.

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Submitted: 01 Mar 2017
Accepted: 03 Jun 2017
ePublished: 09 Jun 2017
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