Abstract | BACKGROUND AND OBJECTIVES: DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a matched-cohort, single-center, controlled study, the outcome of 12 new incident patients who had idiopathic membranous nephropathy and nephrotic syndrome and received a B cell-driven treatment was compared with that of 24 historical reference patients who were given the standard protocol of four weekly doses of 375 mg/m2. RESULTS: Only one patient needed a second dose to achieve full CD20 cell depletion. At 1 yr, time course of the components of nephrotic syndrome and the proportion of patients who achieved disease remission (25%) was identical in both groups. Persistent CD20 cell depletion was achieved in all patients. Costs for rituximab treatment and hospitalizations totalled 3770.90 euros ($4902.20) and 13,977.60 euros ($18,170.80) with the B cell-driven and the four-dose protocol, respectively. One patient on standard protocol had a severe adverse reaction at second rituximab dose. Thus, B cell titrated as effectively as standard rituximab treatment achieves B cell depletion and idiopathic membranous nephropathy remission but is fourfold less expensive, allowing for more than 10,000 euros, approximately $13,000 in savings per patient. CONCLUSIONS: Avoiding unnecessary reexposure to rituximab is extremely cost-saving and may limit the production of antichimeric antibodies that may increase the risk for adverse reactions and prevent re-treatment of disease recurrences.
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Authors | Paolo Cravedi, Piero Ruggenenti, Maria Chiara Sghirlanzoni, Giuseppe Remuzzi |
Journal | Clinical journal of the American Society of Nephrology : CJASN
(Clin J Am Soc Nephrol)
Vol. 2
Issue 5
Pg. 932-7
(Sep 2007)
ISSN: 1555-905X [Electronic] United States |
PMID | 17702725
(Publication Type: Controlled Clinical Trial, Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Immunologic Factors
- Rituximab
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Topics |
- Antibodies, Monoclonal
(administration & dosage)
- Antibodies, Monoclonal, Murine-Derived
- B-Lymphocytes
- Cohort Studies
- Female
- Glomerulonephritis, Membranous
(blood, drug therapy)
- Humans
- Immunologic Factors
(administration & dosage)
- Lymphocyte Depletion
(methods)
- Male
- Middle Aged
- Rituximab
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