Division of Nephrology, RWTH Aachen University Hospital, Aachen, Germany.
Division of Nephrology, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Kidney Int. 2021 Apr;99(4):811-813. doi: 10.1016/j.kint.2020.11.019.
The STARMEN trial postulated that in primary membranous nephropathy (pMN) treatment with tacrolimus plus rituximab would be superior to a traditional Ponticelli regimen of alternating cyclophosphamide and glucocorticoids. This was not the case. Significantly more remissions were achieved in cyclophosphamide-treated patients, and more of these were complete remissions. Considering these results with those of the Mentor trial, which compared rituximab with cyclosporine in pMN, we offer an evidence-based perspective on the role of calcineurin inhibition for pMN treatment.
STARMEN 试验推测，在原发性膜性肾病（pMN）中，他克莫司联合利妥昔单抗治疗优于传统的交替使用环磷酰胺和糖皮质激素的 Ponticelli 方案。但事实并非如此。接受环磷酰胺治疗的患者获得缓解的比例显著更高，且完全缓解的比例更多。考虑到 STARMEN 试验的结果，该试验比较了利妥昔单抗与环孢素在 pMN 中的作用，以及 Mentor 试验的结果，我们提供了基于证据的观点，即钙调神经磷酸酶抑制在 pMN 治疗中的作用。
