Abstract
In present era, drugs like steroids, cytotoxic drugs and calcineurin inhibitors are the backbone to treat immune mediated glomerular diseases. Failure of these therapies often results in persistence of proteinuria, refractory illness and later chronic kidney diseases. The quests to find an answer to such diseases have resulted in the introduction of monoclonal antibodies or target specific drugs. Rituximab is the first monoclonal antibody, which was studied extensively in pauci-immune glomerulonephritis and is now approved for its role in refractory and new onset renal vasculitis. Belimumab has shown role in active systemic lupus erythematous (SLE). With increasing insight in glomerular pathophysiology, many new monoclonal antibodies are now being under trial. Their encouraging results allowed further research on target cytokines, inflammatory mediators and different lymphocyte populations. This review shall discuss monoclonal and their emerging role in glomerulonephritis.
Highlights
Rituxivas studyIncluded 44 patients of new onset ANCA associated renal vasculitis
In GN, rituximab is the first extensively used and successful monoclonal drug
OKT3 was the first monoclonal drug used in Rituximab in ANCA Vasculitis
Summary
Included 44 patients of new onset ANCA associated renal vasculitis. Rituximab on day 0,7,14 and 21 was given with 2 doses of cyclophosphamide on day 0 and 14 in induction and compared with IV CYP and prednisolone therapy. Results showed sustained remission of 76% in rituximab versus 82% in cyclophosphamide group at one year. No significant difference in the outcome of two therapies was noted [6]
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