Volume 24 Issue 5
May  2026
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Article Navigation >  Chinese Journal of General Practice  > 2026  >  24(5): 743-746
ZHANG Hongchuan, ZHU Huaxia, GUO Kaiqi, XU Xingcheng, LI Xiaowei. Comparison of therapeutic effects and cumulative remission rates of different treatment regimens for first-episode, treatment IMN[J]. Chinese Journal of General Practice, 2026, 24(5): 743-746. doi: 10.16766/j.cnki.issn.1674-4152.004481
Citation: ZHANG Hongchuan, ZHU Huaxia, GUO Kaiqi, XU Xingcheng, LI Xiaowei. Comparison of therapeutic effects and cumulative remission rates of different treatment regimens for first-episode, treatment IMN[J]. Chinese Journal of General Practice, 2026, 24(5): 743-746. doi: 10.16766/j.cnki.issn.1674-4152.004481
shu

Comparison of therapeutic effects and cumulative remission rates of different treatment regimens for first-episode, treatment IMN

doi: 10.16766/j.cnki.issn.1674-4152.004481

  • Department of Nephrology, Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui 236000, China

Funds:

 2022e07020057

 AHWJ2024Aa20394

 FYZDYF2023LCYX002

  • Received Date: 2025-07-11
    Available Online: 2026-10-23
    Abstract
  •   Objective  This study aimed to compare the clinical efficacy and remission characteristics of three initial therapeutic strategies—symptomatic treatment, glucocorticoid combined with cyclophosphamide (GC+CYC), and glucocorticoid combined with calcineurin inhibitors (GC+CNIs)—and to further analyze subgroup differences and outcomes after treatment switching, thereby providing a reference for individualized clinical management.  Methods  A total of 231 patients with IMN diagnosed at Fuyang People's Hospital of Anhui Medical University from January 2017 to December 2022 were selected as study subjects. According to the initial treatment regimen, they were divided into three groups: symptomatic treatment group (n=45), GC+CYC group (n=77), and GC+CNIs group (n=109). Clinical efficacy and remission outcomes were compared among groups.  Results  The overall clinical remission rate of IMN patients was 59.74% (138/231), among which the partial remission rate was 24.24% (56/231) and the complete remission rate was 35.50% (82/231). The overall clinical remission rates in the symptomatic treatment, GC+CYC group, and GC+CNIs group were 40.00% (18/45), 59.74% (46/77), and 67.89% (74/109), respectively, with no significant difference between the latter two groups (P>0.05). At follow-up, cumulative clinical remission rates were significantly higher in the GC+CYC group and the GC+CNIs group than in the symptomatic treatment group (P < 0.05). The GC+CNIs group had significantly higher cumulative clinical remission rates than the GC+CYC group at 3, 6, and 9 months (P < 0.05). No significant differences in efficacy were observed between the modified Italian subgroup and the CYC shock subgroup, or between the cyclosporine A subgroup and the tacrolimus subgroup (P>0.05). There was no significant difference in the efficacy of patients who switched from the symptomatic treatment group to the immunosuppressive group compared with patients receiving initial CYC or CNIs.  Conclusion  Although no significant difference in efficacy was observed between the CYC regimen and the CNIs-based regimen, CNIs regimen demonstrated a more rapid therapeutic effect. Subgroup analyses showed comparable efficacy across regimens, and treatment switching may partially improve remission outcomes.

     

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    • References(17)
  • [1]
    Kidney Disease: Improving Global Outcomes (KDIGO) Glomerular Diseases Work Group. KDIGO 2021 Clinical practice guideline for the management of glomerular diseases[J]. Kidney Int, 2021, 100(4s): S1-S276. DOI: 10.1016/j.kint.2021.05.021.
    [2]
    LI W Y, CEN J, QI D L, et al. Effects of immunosuppressive therapy on renal prognosis in primary membranous nephropathy[J]. BMC Nephrol, 2024, 25(1): 377. DOI: 10.1186/s12882-024-03796-4.
    [3]
    YANG Y, ZHANG Y, ZHANG R, et al. Evaluation of immunotherapy for idiopathic membranous nephropathy based on risk stratification and pathological stage[J]. Eur J Pharmacol, 2025. DOI: 10.1016/j.ejphar.2025.177739.
    [4]
    WEI X J, LONG M T, FAN Z Y, et al. Prediction of immunotherapy response in idiopathic membranous nephropathy using deep learning-pathological and clinical factors[J]. Front Endocrinol (Lausanne), 2024, 15: 1328579. DOI: 10.3389/fendo.2024.1328579.
    [5]
    HE H G, HUANG Y Y, LIANG Q Q, et al. Calcineurin inhibitors or cyclophosphamide in the treatment of membranous nephropathy superimposed with FSGS lesions: a retrospective study from China[J]. Ren Fail, 2023, 45(2): 2253930. DOI: 10.1080/0886022x.2023.2253930.
    [6]
    杨浩, 谢丽萍, 何静, 等. 不同地区对膜性肾病影响因素及中医药治疗[J]. 实用中医内科杂志, 2024, 38(1): 13-15.

    YANG H, XIE L P, HE J, et al. The influence of different regions on membranous nephropathy and the treatment of traditional Chinese medicine[J]. Journal of Practical Traditional Chinese Internal Medicine, 2024, 38(1): 13-15.
    [7]
    YU S S, SUN J. A review of progress on complement and primary membranous nephropathy[J]. Medicine (Baltimore), 2024, 103(29): e38990. DOI: 10.1097/md.0000000000038990.
    [8]
    WU L Z, LAI J, LING Y X, et al. A review of the current practice of diagnosis and treatment of idiopathic membranous nephropathy in China[J]. Med Sci Monit, 2021, 27: e930097. DOI: 10.12659/msm.930097.
    [9]
    谢怀娅, 李超, 文煜冰, 等. 钙调磷酸酶抑制剂和环磷酰胺对2型糖尿病患者中特发性膜性肾病的疗效和预后比较[J]. 协和医学杂志, 2020, 11(3): 296-300.

    XIE H Y, LI C, WEN Y B, et al. Efficacy and Prognosis of Calcineurin inhibitors and Cyclophosphamide in Treating Idiopathic Membranous Nephropathy in Patients with Type 2 Diabetes[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 296-300.
    [10]
    WANG J L, BIAN D, SUN J. Effect of cyclophosphamide combined with glucocorticoid therapy on idiopathic membranous nephropathy: a multicenter open-label randomized controlled trial[J]. Clin Nephrol, 2024, 102: 51-58. doi: 10.5414/CN111287
    [11]
    BOSE B, CHUNG E Y M, HONG R, et al. Immunosuppression therapy for idiopathic membranous nephropathy: systematic review with network meta-analysis[J]. J Nephrol, 2022, 35(4): 1159-1170. doi: 10.1007/s40620-022-01268-2
    [12]
    陈博文, 吴雪平, 刘磊, 等. 利妥昔单抗与他克莫司在膜性肾病中的临床应用[J]. 中华全科医学, 2025, 23(4): 580-583. doi: 10.16766/j.cnki.issn.1674-4152.003955

    CHEN B W, WU X P, LIU L, et al. Comparison of the efficacy of rituximab and tacrolimus in the treatment of idiopathic membranous nephropathy[J]. Chinese Journal of General Practice, 2025, 23(4): 580-583. doi: 10.16766/j.cnki.issn.1674-4152.003955
    [13]
    XU W Y, ZHANG Z Q, LI D D, et al. Immunosuppressive therapy for progressive idiopathic membranous nephropathy: a cost-effectiveness analysis in China[J]. BMC Health Serv Res, 2023, 23(1): 361. DOI: 10.1186/s12913-023-09365-z.
    [14]
    LU L Y, CAI S S, ZHU H Y, et al. Comparations of efficacy and safety of rituximab, calcineurin inhibitors and cyclophosphamide in primary membranous nephropathy: a single-center retrospective analysis[J]. BMC Nephrol, 2024, 25(1): 473. DOI: 10.1186/s12882-024-03912-4.
    [15]
    ZHANG Y F, XIE J T, LU M, et al. The outcomes of primary membranous nephropathy treated with cyclophosphamide are superior to calcineurin inhibitors in patients with renal vascular lesions: a multi-center retrospective cohort study[J]. Int Immunopharmacol, 2024, 143(Pt 2): 113379. DOI: 10.1016/j.intimp.2024.113379.
    [16]
    SUN M Y, HUANG J, DONG J W, et al. Comparative analysis of the efficacy of different treatments for idiopathic membranous nephropathy: a retrospectively real-world study[J]. Current medical research and opinion, 2023, 39(5): 761-769. doi: 10.1080/03007995.2023.2192608
    [17]
    孙烜, 张坤英. 钙调磷酸酶抑制剂致肾损伤的研究进展[J]. 中国医药导报, 2023, 20(24): 48-51.

    SUN X, ZHANG K Y. Research progress on renal injury induced by calcineurin inhibitor[J]. China Medical Herald, 2023, 20(24): 48-51.
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