Rituximab in primary membranous nephropathy: a comparative study of three dosing regimens

Primary membranous nephropathy (PMN) is the most common cause of adult-onset nephrotic syndrome worldwide 1. Recently, promising results of two randomized trials 2, 3 and a few observational studies propounded the use of rituximab as the primary therapy in anti-proteinuric refractory PMN. Authors worldwide administer varying dosage schedules of rituximab in the management of PMN with reasonable success. Into the bargain of efficacy, the cost of rituximab needs to be reckoned with, and a higher dose is extortionate. The economic implication of the therapy needs factoring, especially in a limited-resource setting. In light of these facts, we partook an analysis of three dosing regimens of rituximab therapy viz 375 mg/m2 weekly for 4 weeks (Regimen 1), 1 g on Days 0 and 15 (patients who did not achieve any clinical remission at Month 3 and had a cluster of differentiation (CD19) count of >1%...