Goodpasture Syndrome: What to Do When Rituximab or Mycophenolate Mofetil Has Not Achieved Anti-GBM Antibody Reduction
In anti-GBM disease (Goodpasture syndrome), the previous treatment line aims to reduce circulating anti-GBM antibodies. When that goal is not met — whether with rituximab or mycophenolate mofetil — a next-line approach for severe and/or refractory disease becomes necessary.
Previous Treatment & Failure Condition
The prior regimen incorporated rituximab (as a replacement for cyclophosphamide) or, alternatively, mycophenolate mofetil. The treatment target — reduction of anti-GBM antibodies — was not achieved, triggering escalation to this protocol.
Next-Line Approach
For severe and/or refractory anti-GBM disease, the next step involves an add-on therapeutic strategy. The complete protocol — covering agent selection, sequencing, and monitoring criteria — is provided in the full structured regimen.
Clinical Goal
Complete clearance of anti-GBM antibodies.
References
DOI: 10.55563/clinexprheumatol/tep3k5
Imlifidase has been proposed as an alternative to plasmapheresis in refractory forms of anti-GBM disease.
Add on therapy in severe and/or forms of anti-GBM disease.
A rapid and complete clearance of antibodies was demonstrated.
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