SaO022EFFECT OF BELIMUMAB ON PROTEINURIA AND ANTI-PLA2R AUTOANTIBODY IN IDIOPATHIC MEMBRANOUS NEPHROPATHY - 6 MONTHS DATA

Willcocks, Lisa; Barrett, Christine; Brenchley, Paul; Schmidt, Tim; Gisbert, Sophie; Cai, Gengqian; Savage, Caroline O.S.; Jones, Rachel

doi:10.1093/ndt/gfv149.03

Cited by 10 publications

(7 citation statements)

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“…In this case, Belimumab acts by reducing the production of autoantibodies by binding to a B-lymphocyte Stimulator (BLyS) [100]. In a study involving 14 patients, it was found that Belimumab caused significant reduction in anti-PLA 2 R and proteinuria and normalized the serum albumin level [101].…”

Section: Treatment Of Idiopathic Mgn and Further Therapymentioning

confidence: 99%

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

et al. 2019

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The detection of phospholipase A2 receptor (PLA2R) and thrombospondin domain containing 7A THSD7A among primary membranous glomerulonephritis (MGN) patients transformed the diagnosis, treatment monitoring, and prognosis. Anti-PLA2R can be detected in 70–90% of primary MGN patients while anti-THSD7A in 2–3% of anti-PLA2R negative primary MGN patients depending on the technique used. Serum and urine samples are less invasive and non-invasive, respectively, and thus can detect the presence of anti-PLA2R and anti-THSD7A with higher sensitivity and specificity, which is significant in patient monitoring and prognosis. It is better than exposing patients to a frequent biopsy, which is an invasive procedure. Different techniques of detection of PLA2R and THSD7A in patients’ urine and sera were reviewed to provide newer and alternative techniques. We proposed the use of biomarkers (PLA2R and THSD7A) in the diagnosis, treatment decision, and follow-up of patients with primary MGN. In addition, other prognostic renal biomarkers like retinol binding protein (RBP) and beta-2 microglobulin were reviewed to detect the progression of renal damage for early intervention.

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Section: Treatment Of Idiopathic Mgn and Further Therapymentioning

confidence: 99%

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

et al. 2019

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“…Belimumab targets soluble B lymphocyte stimulator and might induce apoptosis of autoreactive B cells [67]. In a study of 14 patients with anti-PLA 2 R-positive MN, administration of belimumab significantly decreased anti-PLA 2 R antibody levels, decreased proteinuria, and normalized serum albumin levels [68].…”

Section: Potential Therapies For Mnmentioning

confidence: 99%

Membranous Nephropathy: Approaches to Treatment

Bomback

Fervenza

2018

Am J Nephrol

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Background: Membranous nephropathy (MN) is a common cause of nephrotic syndrome in adults. This review focuses on mechanisms involved in the pathogenesis of MN and approaches to treatment of this disease. Summary: Our understanding of the pathogenesis of primary MN has advanced greatly with the identification of M-type phospholipase A₂ receptor and thrombospondin type-1 domain-containing 7A as target antigens whose antibodies serve as biomarkers of this disease. Additional research, including investigations into the roles of complement and melanocortin receptors on the podocyte, may further improve our understanding of how best to treat this condition. Immunosuppressive therapies, including corticosteroids alternating with alkylating agents, and calcineurin inhibitors are partially successful in reducing proteinuria in MN, but their use may be associated with significant adverse effects and a high relapse rate. Novel interventions, including targeting B cells with rituximab as well as treatment with adrenocorticotropic hormone (ACTH), are being investigated. Key Messages: The understanding of treatment targets and availability of new biomarkers has facilitated diagnosis and improved risk stratification for MN and may also be useful for individualizing treatment with a wider range of therapeutic options for patients with MN. Considerable evidence supports the use of B-cell depletion as initial therapy in nephrotic patients with MN. ACTH should be considered for patients who do not respond to traditional therapies such as alkylating agents and calcineurin inhibitors.

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“…The B lymphocyte stimulator protein (BLyS, also known as BAFF) is a soluble member of the tumor necrosis factor family, which plays a fundamental role in B lymphocyte activation and differentiation [88]. Belimumab, a monoclonal antibody directed against BLyS, has been tested in 14 proteinuric patients with antiPLA2R-positive primary MN from six different centers in UK [89]. The treatment protocol consisted in 10 mg/kg iv belimumab every 4 weeks for at least 28 weeks up to week 100 (frequency increased to every 2 weeks if urine protein-creatinine ratio >1000 mg/mmol) and supportive therapy.…”

Section: Novel Therapeutic Perspectivesmentioning

confidence: 99%

Treatment of primary membranous nephropathy: where are we now?

et al. 2017

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In the last 10 years, basic science and clinical research have made important contributions to the understanding and management of primary membranous nephropathy (MN). The identification of antibodies directed against the M-type phospholipase A receptor (PLA2R) and thrombospondin type-1 domain-containing 7A protein have added a new perspective on diagnosis, monitoring the immunological activity, predicting prognosis and guiding therapy in patients with primary MN. Mounting evidence suggests that quantification and follow-up of antiPLA2R Abs levels can help in assessing prognosis and evaluate the response to treatment. The kidney disease improving global outcomes guidelines published in 2012 have not been updated. New data on the use of rituximab suggest it should be considered as a potential initial therapy in the treatment of patients with primary MN.

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SaO022EFFECT OF BELIMUMAB ON PROTEINURIA AND ANTI-PLA2R AUTOANTIBODY IN IDIOPATHIC MEMBRANOUS NEPHROPATHY - 6 MONTHS DATA

Cited by 10 publications

References 0 publications

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

Primary Membranous Glomerulonephritis: The Role of Serum and Urine Biomarkers in Patient Management

Membranous Nephropathy: Approaches to Treatment

Treatment of primary membranous nephropathy: where are we now?

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