Which induction therapy is listed for antibody-mediated GN including lupus nephritis, ANCA, anti-GBM disease, and cryoglobulinemia?

Which induction therapy is listed for antibody-mediated GN including lupus nephritis, ANCA, anti-GBM disease, and cryoglobulinemia?

• A. Steroids, cyclophosphamide, and mycophenolate
• B. Rituximab alone
• C. Tacrolimus alone
• D. Antibiotics

Answer: (A)

Induction therapy for antibody-mediated glomerulonephritis relies on rapid, broad immunosuppression to stop autoantibody production and curb immune injury. High-dose corticosteroids are used first to quickly blunt the inflammatory response. To achieve durable suppression of lymphocytes, an alkylating agent such as cyclophosphamide is added; this combination has long been a cornerstone for diseases like lupus nephritis, ANCA-associated GN, anti-GBM disease, and cryoglobulinemic GN. Mycophenolate mofetil can be used as an alternative induction agent in lupus nephritis and in certain cryoglobulinemic settings, pairing well with steroids to control the immune attack. Using rituximab alone doesn’t provide the same rapid, broad immunosuppression needed for induction in these conditions, and tacrolimus alone isn’t sufficient for induction in this antibody-driven context. Antibiotics don’t address the underlying immune process.

Induction therapy for antibody-mediated glomerulonephritis relies on rapid, broad immunosuppression to stop autoantibody production and curb immune injury. High-dose corticosteroids are used first to quickly blunt the inflammatory response. To achieve durable suppression of lymphocytes, an alkylating agent such as cyclophosphamide is added; this combination has long been a cornerstone for diseases like lupus nephritis, ANCA-associated GN, anti-GBM disease, and cryoglobulinemic GN. Mycophenolate mofetil can be used as an alternative induction agent in lupus nephritis and in certain cryoglobulinemic settings, pairing well with steroids to control the immune attack. Using rituximab alone doesn’t provide the same rapid, broad immunosuppression needed for induction in these conditions, and tacrolimus alone isn’t sufficient for induction in this antibody-driven context. Antibiotics don’t address the underlying immune process.