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<p>Rituximab has been advocated for as the first treatment choice&#xa0;for idiopathic membranous nephropathy. Currently, low-dose rituximab protocols are being implemented for the treatment of primary membranous nephropathy with CD19 B-cell monitoring in resource-limited settings. CD19 monitoring is a recently established monitoring tool for determining the optimal response to rituximab treatment, especially when using low-dose rituximab. This manuscript identifies the&#xa0;problems encountered with rituximab&#xa0;treatment, pitfalls in CD19 monitoring and its performance in relation to conventional monitoring tools like anti-PLA2R levels, level of&#xa0;proteinuria, and estimated glomerular filtration rate (eGFR). This article highlights the utility of low-dose, tailor-made regimens of rituximab in the Indian subcontinent with CD19 B cell monitoring to verify appropriate clinical response, along with the economic benefits of such modified regimens in resource-limited settings, based on current scientific evidence.</p> Graphical abstract <p></p>

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Molecular markers or clinical end points? What is the optimal monitoring tool for low-dose rituximab in membranous nephropathy in resource-limited settings?

  • 期刊论文

  • 发表日期：

    2025年4月7日

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  • Gerry George Mathew

摘要

Rituximab has been advocated for as the first treatment choice for idiopathic membranous nephropathy. Currently, low-dose rituximab protocols are being implemented for the treatment of primary membranous nephropathy with CD19 B-cell monitoring in resource-limited settings. CD19 monitoring is a recently established monitoring tool for determining the optimal response to rituximab treatment, especially when using low-dose rituximab. This manuscript identifies the problems encountered with rituximab treatment, pitfalls in CD19 monitoring and its performance in relation to conventional monitoring tools like anti-PLA2R levels, level of proteinuria, and estimated glomerular filtration rate (eGFR). This article highlights the utility of low-dose, tailor-made regimens of rituximab in the Indian subcontinent with CD19 B cell monitoring to verify appropriate clinical response, along with the economic benefits of such modified regimens in resource-limited settings, based on current scientific evidence.

Graphical abstract