Does Rituximab treat kidney disease?

Anti-CD20monoclonal antibody rituximab (RTX), which specifically depletesB cells, is effective in treating various immune-mediated glomerular diseases. Administration of rituximabhas been shown to be reliable and efficient, particularly in patients with ANCAassociated vasculitis, who predominantly present with non-nephrotic proteinuria. In such patients, stable long-termBcell depletion is often easily achieved using standard dosing regimens. However, in patients with nephrotic syndrome and non-selective proteinuria, rituximab pharmacokinetics are profoundly altered and rituximab cannot be maintained at sufficiently high levels for a long enough period of time, which may render rituximab therapy ineffective. Because complement-derived cytotoxicity is one of the important modes of action of rituximab, hypocomplementemia often associated with systemic lupus erythematosus may hinder the efficacy of rituximab in patients with lupus nephritis.

This review describes the pharmacokinetics and pharmacodynamics of rituximab in several selected glomerular diseases, as well as the effect of proteinuria, anti-drug antibodies, and other clinical variables on RTX clearance and volume of distribution. The effects of plasma exchange and peritoneal dialysis onrituximabclearance are also discussed. Potential associations between pharmacokinetic and pharmacodynamic changes in various glomerular diseases affecting the kidney, the sustainability of Bcell depletion, and the clinical efficacy of rituximab are reviewed, and potential dosing recommendations are made. The role of therapeutic drug monitoring in tailoring treatment is also discussed, and various previously tested rituximabdosing regimens are compared based on their clinical and laboratory treatment responses. As alternative antiCD20molecules may be effective in rituximabnon-responders, their pharmacokinetics, pharmacodynamics, and current role in the treatment of glomerular disease are also addressed. If you want to get more high-quality information, you can contact YaDE. YaDE will do its best to learn more about high-quality overseas drugs for you.