Int. Rev. Allergol. Clin. Immunol. Family Med., 2015, XXI/2: 092-097 Maximize

Int. Rev. Allergol. Clin. Immunol. Family Med., 2015, XXI/2: 092-097

Title: Rituximab – a new treatment option in nephrology 

Authors: Brodowska-Kania D, Rymarz A, Niemczyk S

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Rituximab – a new treatment option in nephrology

Brodowska-Kania D, Rymarz A, Niemczyk S.

Military Institute of Medicine in Warsaw, Poland, Central Clinical Hospital of the Ministry of National Defense, Department of Internal Diseases, Nephrology and Dialysis

Int. Rev. Allergol. Clin. Immunol. Family Med., 2015; Vol. 21, No. 2, 92

Rituximab (RTX) is a depleting monoclonal antibody directed against protein CD20 placed on a surface of B-lymphocytes. In recent years biologic agents have enriched our armory and indications for their introductions have significantly widened. FDA approved RTX application in severe, resistant and recurrent ANCA associated vasculitis (AAV). This medication can be used also in severe cases of lupus erythematosus, mixed cryoglobulinemia and primary glomerulonephritis like membranous nephropathy in adults and minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS) in children. Side effects are associated mainly with drug infusion and reveal as a cytokine release syndrome. Late complications after RTX therapy include neutropenia, reactivation of latent viral infections like HBV or progressive multifocal leukoencephalopathy (PML) and very rarely interstitial lung disease (RTX-associated ILD). RTX treatment can cause opportunistic infections therefore pneumocystis prophylaxis is recommended. Development of clinical immunology can result in the enrichment of indications for RTX treatment as a rescue therapy. High cost of this medication and lack of suitable reimbursement by national system of medical insurance are the main barriers for its application in Poland.

Key words: rituximab, monoclonal antibody, monoclonal antibody, biological agents, glomerulonephritis