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Rituximab-treated membranous lupus nephritis: clinical outcome and effects on electron dense deposits
  1. Thórunn Jónsdóttir1,
  2. Birgitta Sundelin2,
  3. Elisabet Welin Henriksson3,
  4. Ronald F van Vollenhoven1,
  5. Iva Gunnarsson1
  1. 1Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  2. 2Department of Pathology and Cytology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  3. 3Department of Neurobiology, Care Sciences and Society, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Thórunn Jónsdóttir, Department of Medicine, Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, S-171 76 Stockholm, Sweden; thorunn.jonsdottir{at}karolinska.se

https://doi.org/10.1136/ard.2010.129288

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    Membranous lupus nephritis (MLN) is characterised by proteinuria, a risk of the development of nephrotic syndrome and progressive deterioration in renal function. Despite the usage of various immunosuppressive agents, no solid, evidence-based recommendations for the treatment of MLN have been established and new therapeutic strategies are needed in therapy-resistant cases.1

    During the past few years, rituximab has evolved as a promising new agent in severe lupus nephritis.2,–,4 The aim of this study was to evaluate the clinical and histopathological response to treatment with rituximab plus cyclophosphamide in patients with severe and therapy-resistant MLN.

    Six female patients with MLN confirmed at a recent renal biopsy were included. The patients were selected for having proteinuria of 2 g/24 h or greater and recent/previous failure of conventional immunosuppressive agents. All patients were treated with ACE and/or, angiotensin II receptor blockers. In all cases, at least four of the American College of Rheumatology criteria for …

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    Footnotes

    • Competing interests TJ and IG have received honoraria (less than US$10 000 each author) from Roche.

    • Patient consent Obtained.

    • Ethics approval This study was conducted with the approval of the Regionala etikprövningskommittén, Stockholm and the Swedish Medical Product Agency.

    • Provenance and peer review Not commissioned; externally peer reviewed.