Role of rituximab therapy in glomerulonephritis.

B cell depletion with the monoclonal antibody rituximab is attracting increasing attention in systemic lupus erythematosus, vasculitis, and primary glomerulonephritis. Existing, uncontrolled data report high response rates in patients with refractory disease. If supported by the results of ongoing randomized trials, then rituximab and related B cell-depleting or -modulating drugs are likely to become a component in the future management of these disorders. Their use may improve patient outcomes by permitting more complete disease control and reduced exposure to glucocorticoid and traditional immunosuppressive drugs. The toxicity and infective risk of B cell-targeted agents in renal disease needs to be determined as well as their optimal dosing in combination with conventional agents.