Antibody-Guided Therapy in Phospholipase A2 Receptor-Associated Membranous Nephropathy.

ABSTRACT:

Introduction

A 6-month course of cyclophosphamide (CP) and steroids is effective in primary membranous nephropathy (MN), but unappealing because of long-term side effects. We evaluated efficacy of an "antibody-guided" treatment schedule.

Methods

Patients with phospholipase A2 receptor (PLA2R)-related MN and high risk of progression were treated with CP 1.5 mg/kg/d and steroids in cycles of 8 weeks. Anti-PLA2R antibodies were measured by indirect immunofluorescence (IIFT) at 8, 16, and 24 weeks, and a negative test resulted in withdrawal of CP, and rapid tapering of prednisone. In patients with persistent anti-PLA2R antibodies at 24 weeks, CP was switched to mycophenolate mofetil. Treatment was repeated in patients with a relapse.

Results

Our analysis included 65 patie

SUBMITTER: Vink CH 

PROVIDER: S-EPMC10014436 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature