Rituximab for the treatment of refractory anti-glomerular basement membrane disease

Background Anti-glomerular basement membrane (anti-GBM) disease is a rare but severe autoantibody-mediated immune disorder. The typical clinical presentation includes rapidly progressive glomerulonephritis and often concurrent pulmonary hemorrhage. The present study is aimed to investigate the therapeutic effects of rituximab either used alone or with other immunosuppressants. Methods Eight patients diagnosed with anti-GBM disease and treated with rituximab from 2014 to 2020 were retrospectively reviewed. Results Eight patients included 5 males and 3 females with a median age of 58.5 years. They all presented severe kidney injuries and 1 patient had lung hemorrhage. At diagnosis, the median of serum creatinine was 246 mu mol/L (ranging from 91 to 850 mu mol/L), with 3 patients requiring dialysis. All of them received corticosteroids and plasmapheresis. Rituximab was given as either standard four weekly doses or one pulse ranging from 100 to 600 mg. After a median follow-up of 34.5 months, kidney function was partially recovered or stabilized in 5/8 (62.5%) patients, free of dialysis. Anti-GBM antibodies remained undetected in all patients during follow-up. No severe adverse effect associated with rituximab was observed. Conclusion Rituximab may be an alternative therapy in the treatment of patient with severe or refractory anti-GBM disease.

Automated summary

This study retrospectively reviewed eight patients diagnosed with anti-GBM disease who were treated with rituximab from 2014 to 2020. The results showed that rituximab may be an alternative therapy for patients with severe or refractory anti-GBM disease. After a median follow-up of 34.5 months, kidney function partially recovered or stabilized in 62.5% of the patients, and anti-GBM antibodies remained undetected in all patients during follow-up. No severe adverse effects associated with rituximab were observed.