Clinical analysis of low-dos erituximab in the treatment of refractory idiopathic membranous nephropathy

Objective To explore the efficacy and safety of low-dose rituximab(RTX) for refractory idiopathic membranous nephropathy(IMN).Methods From January 2017 to December 2018,32 cases of refractory IMN with positive anti-PLA2R antibody were collected.They received low-dose RTX treatment and were followed up for 1 year.Results The overall effective rate of low-dose RTX treatment for refractory IMN was 87.50% with a complete remission rate of 62.50% and a partial remission rate of 25.00%.After low-dose RTX treatment,CD19+B cell count,serum levels of total IgG and anti-PLA2R antibody declined markedly(P<0.05) and disease severity was closely correlated with anti-PLA2R antibody level.Adverse reactions of low-dose RTX treatment included agranulocytosis(n=2),hypotension during infusion(n=2) and pulmonary infection(n=1).Conclusion Low-dose rituximab is both effective and safe for refractory IMN.