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12-08-2022 | Research Letter

Intravenous cyclophosphamide as an alternative to the oral cyclophosphamide modified Ponticelli regimen for high-risk PLA2R-positive membranous nephropathy

Authors: Gabriel Ștefan, Adrian Zugravu, Simona Stancu

Published in: Journal of Nephrology | Issue 2/2023

Excerpt

The mainstay of treatment for high-risk primary membranous nephropathy (MN) is the cyclic steroid-oral cyclophosphamide (cs-oral CYC) regimen (modified Ponticelli regimen) [1]. However, there has been increasing awareness of serious treatment-related toxicity [2, 3]. Intravenous CYC (iv-CYC) offers the potential benefit of lower cumulative dose and a lower rate of adverse events [4, 5]. …

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Stefan G, Stancu S, Zugravu A, Popa O, Zubidat D, Petre N, Mircescu G (2022) Negative anti-phospholipase A2 receptor antibody status at three months predicts remission in primary membranous nephropathy. Ren Fail 44(1):258–268. https://doi.org/10.1080/0886022X.2022.2033265CrossRefPubMedPubMedCentral

Scolari F, Delbarba E, Santoro D, Gesualdo L, Pani A, Dallera N, Mani LY, Santostefano M, Feriozzi S, Quaglia M, Boscutti G, Ferrantelli A, Marcantoni C, Passerini P, Magistroni R, Alberici F, Ghiggeri GM, Ponticelli C, Ravani P, Investigators R-C (2021) Rituximab or cyclophosphamide in the treatment of membranous nephropathy: the RI-CYCLO randomized trial. J Am Soc Nephrol. https://doi.org/10.1681/ASN.2020071091CrossRefPubMedPubMedCentral

Luzardo L, Ottati G, Cabrera J, Trujillo H, Garau M, Gonzalez Bedat C, Coitino R, Aunchayna MH, Santiago J, Baldovinos G, Silvarino R, Ferreiro A, Gonzalez-Martinez F, Gadola L, Noboa O, Caorsi H (2020) Substitution of oral for intravenous cyclophosphamide in membranous nephropathy. Kidney 360(9):943–949CrossRef

Mathrani V, Alejmi A, Griffin S, Roberts G (2017) Intravenous cyclophosphamide and oral prednisolone is a safe and effective treatment option for idiopathic membranous nephropathy. Clin Kidney J 10(4):450–454. https://doi.org/10.1093/ckj/sfw152CrossRefPubMedPubMedCentral

Title: Intravenous cyclophosphamide as an alternative to the oral cyclophosphamide modified Ponticelli regimen for high-risk PLA2R-positive membranous nephropathy
Authors: Gabriel Ștefan
Adrian Zugravu
Simona Stancu
Publication date: 12-08-2022
Publisher: Springer International Publishing
Published in: Journal of Nephrology / Issue 2/2023
Print ISSN: 1121-8428
Electronic ISSN: 1724-6059
DOI: https://doi.org/10.1007/s40620-022-01426-6

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