Volume 23 Issue 4
Apr.  2025
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CHEN Bowen, WU Xueping, LIU Lei, CHEN Weidong. 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
Citation: CHEN Bowen, WU Xueping, LIU Lei, CHEN Weidong. 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
shu

Comparison of the efficacy of rituximab and tacrolimus in the treatment of idiopathic membranous nephropathy

doi: 10.16766/j.cnki.issn.1674-4152.003955

  • Department of Nephrology, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

Funds:

 202004j07020011

 2021byzd116

  • Received Date: 2024-09-20
    Available Online: 2025-06-30
    Abstract
  •   Objective  To compare the efficacy and safety of two treatment regimens (rituximab and a small amount of glucocorticoid combined with tacrolimus) for membranous nephropathy in moderate and high risk groups.  Methods  Patients diagnosed with idiopathic membranous nephropathy and phospholipase A2 receptor (PLA2R)-associated membranous nephropathy, who were admitted to the Department of Nephrology at the First Affiliated Hospital of Bengbu Medical University, between January 2020 and June 2023 were selected as medium risk or high risk groups based on clinical manifestations. In accordance with the divergent treatment regimens, the subjects were categorized as follows: the rituximab group underwent rituximab treatment, the tacrolimus group received a low-dose glucocorticoid in combination with tacrolimus. The alterations in serum albumin, 24-hour urinary protein quantity, blood PLA2R antibody, prior to treatment, and at 3 months, 6 months and 12 months following-treatments were observed in both groups. The overall effective rate, recurrence rate, and adverse reactions of the two groups were then compared.  Results  A subsequent investigation revealed no significant difference in the general data between the two groups (P>0.05). The quantitative values of 24-hour urinary protein in the Tacrolimus group after 3 and 6 months of treatment [3.30 (1.46, 4.43) g, 1.35 (0.62, 2.93) g] were superior to those of the RTX group [4.08 (3.05, 4.86) g, 2.19 (1.03, 3.95) g, P < 0.05]. The total remission rate after 12 months of treatment was not statistically significant (P>0.05). The immunological remission rate of 80.43% (37/46) in the rituximab group was marginally higher than 77.61% (52/67) observed in the tacrolimus group; however, this difference did not reach statistical significance. Notably, the recurrence rate in the rituximab group was significantly lower than that observed in the tacrolimus group, with statistical significance (P < 0.05). With regard to adverse reactions, the rate of 8.70% (4 cases) in the rituximab group was lower than the 25.37% (17 cases) observed in the tacrolimus group.  Conclusion  It has been demonstrated that both rituximab and tacrolimus are effective in the treatment of idiopathic membranous nephropathy. However, it is evident that tacrolimus-treated patients exhibit a more rapid treatment effect, while those administered rituximab demonstrate a higher immunological remission rate and longer effective duration of action. Furthermore, rituximab-treated patients exhibit a reduced incidence of side effects and a lower recurrence rate.

     

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