{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:32:33Z","timestamp":1790353953893,"version":"4.1.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2017,9]]},"abstract":"\n Guidelines recommend steroid plus cyclical cyclophosphamide (S\n t<\/jats:sc>\n -C\n p<\/jats:sc>\n ) therapy for patients with idiopathic membranous nephropathy at high risk of progression to ESRD. Rituximab (R\n tx<\/jats:sc>\n ) may be a safer alternative. In this retrospective, observational cohort study, we compared time to any adverse event (primary outcome); serious or nonserious events; partial and complete remission of the nephrotic syndrome; and a composite of doubling of serum creatinine, ESRD, or death between 100 R\n tx<\/jats:sc>\n -treated patients and 103 patients who received daily S\n t<\/jats:sc>\n -C\n p<\/jats:sc>\n . We monitored patients with standardized protocols and adjusted for baseline characteristics by Cox regression. Over a median follow-up of 40 months, the R\n tx<\/jats:sc>\n group had significantly fewer adverse events than the S\n t<\/jats:sc>\n -C\n p<\/jats:sc>\n group (63 versus 173;\n P<\/jats:italic>\n <0.001), both serious (11 versus 46;\n P<\/jats:italic>\n <0.001) and nonserious (52 versus 127;\n P<\/jats:italic>\n <0.001). Cumulative incidence of any first (35.5% versus 69.0%;\n P<\/jats:italic>\n <0.001), serious (16.4% versus 30.2%;\n P<\/jats:italic>\n =0.002), or nonserious (23.6% versus 60.8%;\n P<\/jats:italic>\n <0.001) event was significantly lower with R\n tx<\/jats:sc>\n . Adjusted hazard ratios (95% confidence intervals) between R\n tx<\/jats:sc>\n and S\n t<\/jats:sc>\n -C\n p<\/jats:sc>\n groups were 0.27 (0.16 to 0.44) for any first adverse event, 0.32 (0.15 to 0.68) for serious adverse events, and 0.23 (0.13 to 0.41) for nonserious adverse events. Although the cumulative incidence of partial remission was lower in the R\n tx<\/jats:sc>\n group, rates of complete remission and the composite renal end point did not differ significantly between groups. Because of its superior safety profile, we suggest that R\n tx<\/jats:sc>\n might replace S\n t<\/jats:sc>\n -C\n p<\/jats:sc>\n as first-line immunosuppressive therapy in patients with idiopathic membranous nephropathy and nephrotic syndrome.\n <\/jats:p>","DOI":"10.1681\/asn.2016091022","type":"journal-article","created":{"date-parts":[[2017,5,9]],"date-time":"2017-05-09T20:25:19Z","timestamp":1494361519000},"page":"2729-2737","source":"Crossref","is-referenced-by-count":173,"title":["Safety of Rituximab Compared with Steroids and Cyclophosphamide for Idiopathic Membranous Nephropathy"],"prefix":"10.1681","volume":"28","author":[{"given":"Jan A.J.G.","family":"van den Brand","sequence":"first","affiliation":[{"name":"Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piero","family":"Ruggenenti","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Azienda Socio Sanitaria Territoriale Ospedale Papa Giovanni XXIII, Bergamo, Italy; and"},{"name":"IRCCS - Instituto di Ricerche Farmacologiche \u201cMario Negri\u201d, Department of Renal Medicine, Clinical Research Center for Rare Diseases \u201cAdo e Cele Dacc\u00f2\u201d, Ranica, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Chianca","sequence":"additional","affiliation":[{"name":"IRCCS - Instituto di Ricerche Farmacologiche \u201cMario Negri\u201d, Department of Renal Medicine, Clinical Research Center for Rare Diseases \u201cAdo e Cele Dacc\u00f2\u201d, Ranica, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia M.","family":"Hofstra","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Perna","sequence":"additional","affiliation":[{"name":"IRCCS - Instituto di Ricerche Farmacologiche \u201cMario Negri\u201d, Department of Renal Medicine, Clinical Research Center for Rare Diseases \u201cAdo e Cele Dacc\u00f2\u201d, Ranica, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"IRCCS - Instituto di Ricerche Farmacologiche \u201cMario Negri\u201d, Department of Renal Medicine, Clinical Research Center for Rare Diseases \u201cAdo e Cele Dacc\u00f2\u201d, Ranica, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack F.M.","family":"Wetzels","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Remuzzi","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Azienda Socio Sanitaria Territoriale Ospedale Papa Giovanni XXIII, Bergamo, Italy; and"},{"name":"IRCCS - Instituto di Ricerche Farmacologiche \u201cMario Negri\u201d, Department of Renal Medicine, Clinical Research Center for Rare Diseases \u201cAdo e Cele Dacc\u00f2\u201d, Ranica, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,5,9]]},"reference":[{"key":"B1-20230819","doi-asserted-by":"crossref","first-page":"609","DOI":"10.2215\/CJN.04160413","article-title":"Glomerular diseases: Membranous nephropathy--A modern view.","volume":"9","author":"Ponticelli","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2-20230819","first-page":"186","article-title":"KDIGO Glomerulonephritis Work Group: KDIGO clinical practice guideline 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