Efficacy and safety of rituximab in primary IgA nephropathy: a retrospective study

Purpose: The study aimed to evaluate the efficacy and safety of rituximab (RTX) in primary IgA nephropathy (IgAN).

Methods: A retrospective review was conducted on the medical records of 22 patients diagnosed with primary IgAN who received RTX treatment. The clinical data, including blood tests, urine examinations and estimated glomerular filtration rate (eGFR), were analyzed at four time point: baseline, 3 months, 6 months and 12 months. Adverse events were also recorded.

Results: Our study included 9 male and 13 female participants. The level of serum albumin significantly increased after three months with RTX applied (P < 0.01). Furthermore, we observed a significant reduction in microalbuminuria and urine albumin-to-creatinine ratio at twelve months (P < 0.01). However, there was no change in serum creatinine (P = 0.08), urinary red blood cell (P = 0.11) or eGFR (P = 0.09) during the course of one year. Two cases achieved complete remission, while eleven cases experienced partial remission, resulting in an overall remission rate of 50.0%. During the treatment period, three patients developed infections and two patients encountered infusion-related adverse reactions.

Conclusion: In our retrospective study, RTX demonstrated a significant improvement in serum albumin levels and a reduction in proteinuria among primary IgAN patients. Although no statistically significant difference was observed in terms of renal function, there was an observable trend towards improvement. Therefore, we propose that RTX may be an alternative treatment option for primary IgAN patients who cannot tolerate glucocorticoids or immunosuppressants.