#NephJC Transcript
Healthcare social media transcript of the #NephJC hashtag.
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See #NephJC Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @jenniejlin I love your #NephJC summary on #MENTOR, especially the background with a lot of history. It was great. Thank you! |
 | Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @rheault_m I agree Michelle #NephJC |
 | Laurence H Beck, Jr @LaurenceHBeckJ1 @HecmagsMD To clarify - I was not part of MENTOR! Wish I had been ... Dr. Fervenza initially offer me the chance to test aPLA2R. #NephJC |
 | Nephrology Journal Club @NephJC Welcome to tonight’s #NephJC chat. We are discussing the July 2019 @NEJM paper “Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy” (MENTOR study). See: https://t.co/sZWBnwaK3M https://t.co/ALkfI2G9xL |
 | Freddy Myat Min Kyaw @FreddyMin RT @NephJC: And do check out this fantastic MENTOR study #NephJC visual abstract by @Stones__! 🙌 https://t.co/l25sssKDAI |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @rheault_m I am looking forward to learning about membranous nephropathy tonight #nephJC |
 | Poyan Mehr @poyanmehr Ali Poyan Mehr from San Francisco. Paternity leave giving me the opportunity to join #NephJC no COI |
| Nephrology Journal Club @NephJC I am Jennie Lin (@jenniejlin), a physician-scientist @NU_Nephrology in Chicago, human guardian of two podocyte-clad hounds, and your host for tonight’s chat! I have no conflicts of interest (COIs). #NephJC https://t.co/GJ7isFAwyE |
 | Michelle Rheault @rheault_m @LaurenceHBeckJ1 and can see even in infants due to anti–neutral endopeptidase antibodies! (Or so I hear. That's kind of a unicorn diagnosis) #NephJC |
| Michelle Rheault @rheault_m RT @LaurenceHBeckJ1: @rheault_m Yes I agree - PLA2R-type MN can occur in early teens. And THSD7A-type MN as early as 4 years old! #NephJC |
| Nephrology Journal Club @NephJC @LaurenceHBeckJ1 Welcome, Larry! #NephJC |
 | Bhavnish @Buck1486 Buck from NorthEast Ohio. No COI. Heard about the Mentor Trial since @ASNKidney annual meeting last year!! Let’s discuss! #nephjc |
 | Angel Cesar Ortiz @AngelCesarOrtiz Hi everyone! Here Angel Ortiz, nephrologist from Mexico 🇲🇽 No COI, just my neph thesis was based on Membranous Nephropathy. Love this #NephJc |
 | Gautam Phadke, MD @gautamphadke Insurance denials are stat now a days. Got kicked out today on classic idiopathic membranous. Anyone have same issue? #NephJC |
 | Mya Htwe Nge @mhtwenge Mya from Myanmar 🇲🇲 Excited for MENTOR #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @rheault_m Or anti-cationic BSA in infants! Also a unicorn. #NephJC |
 | Verner Venegas @Vernisartan Hello! #NephJC my name is Verner. #NSMCIntern2019 CdMx @nefrocmnlr. Ready to roll. Tweetdeck Ready. No COI |
| Nephrology Journal Club @NephJC Please introduce yourself, even if just lurking, and declare any COIs. Don’t forget to add to your tweets the hashtag: #NephJC People track your tweets during and after the chat by searching for this hashtag! https://t.co/e5C0iEhqkU |
 | Natalie McCall @_NatalieMcCall Natalie from VUMC. No COI. Excited for the topic tonight #NephJC |
 | Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah Nikhil Shah from Edmonton, Canada @UAlbertaNeph #NephJC no CoI |
 | Harish Seethapathy @BetterCallSeeth Hi everyone. Harish, Renal Fellow @MGHKidneys. #NSMC Intern. No COI. #NephJC. One of my favorite summaries to date! |
 | Tiffany Caza @Tiff_Caza RT @rheault_m: Children with MN seem to have higher rates of spontaneous remission, lower rates of PLA2R positivity and more favorable kidney outcomes compared to adults, but numbers of pts reported in the literature are low. #NephJC https://t.co/LLJacxPpGC https://t.co/nMpI8dryrk |
 | Kirk Campbell @kirkcampbell Kirk Campbell from NYC. No COI. Looking forward to the discussion #NephJC |
 | Samira Farouk, MD, MSCR @ssfarouk Samira Farouk, transplant nephrologist @ISMMSKidney @Neph_Sim #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @HecmagsMD Hi @HecmagsMD Like wise #NephJC |
 | Edgar V. Lerma 🇵🇭 @edgarvlermamd Edgar Lerma, Chicago-based Nephrologist #NephJC Photo Credit: Barry Butler Photography 📸 https://t.co/eWMVI6KFon https://t.co/BraFpUR9UM |
| Nephrology Journal Club @NephJC For those of you joining your first #NephJC chat, we recommend using the native client in browser https://t.co/LkGCHacSvg or Tweetdeck. Tchat will truncate tweets at 140 characters. #NephJC |
 | Ross Morton @signindoc #NephJC Ross Morton. Nephrologist in Saint John. No COI |
 | Alex Meraz @NephroGuy Alex from Mexico, now on Toronto! No COI. Very excited about #MENTOR #NephJC |
 | Michelle Starr MD MPH @mcstarr1 Michelle Starr, peds nephrology fellow in Seattle (for another few weeks!) looking forward to learning about membranous nephropathy. While rare in kids, really challenging to manage when we see it! #nephjc |
 | Mohamed E. Elrggal @M_Elraggal Hi everyone, I am Mohamed Elrggal, Nephrologist checking from Egypt, No COI, #NephJC |
 | Mario Funes, MD @MarioFunesMD Mario Funes. Internal Medicine chief resident in New Brunswick, NJ. Future Nephrologist! Excited to learn about MN. No COI. #NephJC. |
 | Salem Almaani @SalemAlmaani Salem here from Ohio state. No COI other than being trained by 6 of the authors 😳 #NephJC |
 | Janewit Wongboonsin, MD, MS @janewitwong Janewit, Chief resident at University of Minnesota, No COI. @umnmedresidency. Excited to join #NephJC |
 | Jefferson L. Triozzi, M.D. @nepherson @NephJC Hi, Jefferson from Baylor COM Internal Medicine residency, no COI, Didn't get to read this study yet #lurking #NephJC |
 | Vineet Behera @BeheraVineet I am Vineet behera... nephrologist from mumbai, india.. #nsmc intern.. no COI.. Truly excited about MENTOR.. #nephjc |
 | Stella Shin, MD @BabyBeanDoc Stella Shin, pediatric nephrologist at Emory in Atlanta GA #NephJC |
 | Vanessa Lerma @VanessaLerma17 Helloo everyone!!! Vanessa from Mexico No COI #NephJc |
 | Anna Burgner MD MEHP @anna_burgner Hi #NephJC! Anna Burgner nephrologist @VUMCKidney and APD. No relevant COI. |
 | Pablo Garcia @PabloGarciaMD Pablo Garcia and for the first time I can say second year nephrology fellow @StanfordNeph no CoI #NephJC |
 | L. Parker Gregg @LParkerGregg1 Hi all! Parker from Dallas. Lurking from my phone tonight. No COI #NephJC #NSMC |
 | Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Please introduce yourself, even if just lurking, and declare any COIs. Don’t forget to add to your tweets the hashtag: Please introduce yourself, even if just lurking, and declare any COIs. Don’t forget to add to your tweets the hashtag: #NephJC People track your tweets during and after the chat by searching for this hashtag! https://t.co/e5C0iEhqkU |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil Swapnil Hiremath Nephrologist @ottawarenal #NephJC cofounder Not a GN expert Cyclophosphamide averse No other CoI https://t.co/CGoLX2zMFw |
| Nephrology Journal Club @NephJC If you’re not familiar with our code of conduct, check out the amazing guide to the values of our #NephJC community put together by @Nephro_Sparks and @SLeonMD 🙌 https://t.co/b3Y4ALHhH3 |
 | Nathaniel Reisinger @nephrothaniel Nathaniel Nephrologist #NephJC |
| Nephrology Journal Club @NephJC 📖 Abbreviations for the chat: PMN: primary membranous nephropathy CNI: calcineurin inhibitor RCT: randomized control trial #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk @kirkcampbell Welcome to #NephJC! |
| Michelle Rheault @rheault_m @NephJC Michelle Rheault here. Ped Neph, so don't see MN very often but big glomerular disease fan. COI in bio #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Hector Madariaga. From Cambridge, MA. No COI. Looking forward to discussing this great topic #Nephjc https://t.co/UGBvQBDRJV |
 | Sayna Norouzi, MD, FASN @SaynaNorouzi Hi! Sayna from @NephBCM. No CoI. #nephJC |
 | Vipin Varghese @vipvargh Vipin Varghese, MS4 in New Orleans #NephJC |
 | Itunu @itunuowoyemi Itunu - Onco-Nephrology fellow @MayoClinic . No COI. Great to be here #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: 📖 Abbreviations for the chat: PMN: primary membranous nephropathy CNI: calcineurin inhibitor RCT: randomized control trial #NephJC |
| Mohamed E. Elrggal @M_Elraggal @AngelCesarOrtiz hey angel, welcome #NephJC |
| Nephrology Journal Club @NephJC Check out the background and summary of the MENTOR study: https://t.co/pKIk6Ebtsb Thoroughly enjoyed geeking out about PMN and rituximab to write it! #NephJC |
 | Mei Lin Bissonnette MD PhD FRCPC @BCRenalPath Mei Lin Bissonnette, renal pathologist from Vancouver, BC 🇨🇦. No COI and lurking to learn about treatment #NephJC |
 | Krithika Mohan @krithicism Hi, Krithika here, Nephrology fellow from Hyderabad, India. No COI #NephJC |
 | R Lafayette @kidneybiz #nephJC Interested to hear conversation about our paper, will see if I know how to interact real-time or not, Rich Lafayette |
| Alex Meraz @NephroGuy RT @NephJC: If you’re not familiar with our code of conduct, check out the amazing guide to the values of our #NephJC community put together by @Nephro_Sparks and @SLeonMD 🙌 https://t.co/b3Y4ALHhH3 |
 | Sean Pickthorn @SeanPickthorn Sean Pickthorn, intern a UIowa checking in! Looking forward to the discussion. No COI. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Check out the background and summary of the MENTOR study: https://t.co/pKIk6Ebtsb Thoroughly enjoyed geeking out about PMN and rituximab to write it! #NephJC |
| Tiffany Caza @Tiff_Caza @NephJC Hi! I'm Tiff Caza, NMSC intern and member of pod ⚡. Looking forward to learning and to a lively discussion tonight. No COI. #NephJC |
 | Raymond Hsu @DrRaymondHsu Hi all! Ray here nephrologist from san francisco. no relevant COI #nephjc |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @CristhianMuM @nefrocmnlr Hey Cristhian.. nice visual abstract on #MENTOR #NephJC |
| Michelle Rheault @rheault_m @kirkcampbell Welcome Kirk! Your first #NephJC chat? (Once upon a time, Kirk taught me how to Western Blot) #NephJC |
| Nephrology Journal Club @NephJC Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
 | Sanjeev Nair @Nair_Sanj @NephJC Sanjeev Nair, Nephrologist, Chennai. No CoI. Looking forward to this #NephJC |
| L. Parker Gregg @LParkerGregg1 RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Vipin Varghese @vipvargh RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC Great to see all of the new contributors tonight @Nephro_Sparks @hswapnil + @kidney_boy have done a great job building this community #NephJC |
| Michelle Rheault @rheault_m @janewitwong @umnmedresidency Hi Janewit! Welcome to #NephJC |
 | Hassan Mahmoud @hassan_mohamud Hassan Mahmoud Nephrology fellow @bu_bmc_renal. No COI #nephjc |
| Nephrology Journal Club @NephJC @Stones__ And for the sake of humor, if the MENTOR study were a meme … #NephJC https://t.co/96jDFoLpuQ |
 | Felipe Naranjo @FelipeSNaranjo @NephJC Hello Felipe Naranjo, Nephrology Fellow. From Baltimore. No COI. #NephJC |
| Mohamed E. Elrggal @M_Elraggal @Tiff_Caza @NephJC Hi Tiff #NephJC |
 | Eric Au @ericau RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah #NephJc Wow! What a wonderful crowd here tonight. Nephrology is beautiful! #NSMC in force! |
| Laurence H Beck, Jr @LaurenceHBeckJ1 RT @NephJC: @Stones__ And for the sake of humor, if the MENTOR study were a meme … #NephJC https://t.co/96jDFoLpuQ |
| Alex Meraz @NephroGuy RT @NephJC: Check out the background and summary of the MENTOR study: https://t.co/pKIk6Ebtsb Thoroughly enjoyed geeking out about PMN and rituximab to write it! #NephJC |
| Nephrology Journal Club @NephJC @Stones__ Although on #NephTwitter this past week, this has been happening too … #NephJC https://t.co/fuPMuuAHiI |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD RT @NephJC: @Stones__ And for the sake of humor, if the MENTOR study were a meme … #NephJC https://t.co/96jDFoLpuQ |
 | Timothy Yau @Maximal_Change Tim Yau from @WUNephrology no COI other than I’m still giving cytoxan for severe membranous #NephJC |
| Vineet Behera @BeheraVineet RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Poyan Mehr @poyanmehr @hswapnil @OttawaRenal Yet I think this trial would have been even more informative using cyclophosphamide as comparator. We all knew CNIs are “useless” in MN #NephJC |
 | Joselyn Reyes Bahamonde @jopelina RT @NephJC: @Stones__ And for the sake of humor, if the MENTOR study were a meme … #NephJC https://t.co/96jDFoLpuQ |
| Alex Meraz @NephroGuy RT @NephJC: @Stones__ And for the sake of humor, if the MENTOR study were a meme … #NephJC https://t.co/96jDFoLpuQ |
| Pablo Garcia @PabloGarciaMD Thanks for joining Dr. Lafayette @kidneybiz co-author of the MENTOR trial #nephjc |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @poyanmehr @hswapnil @OttawaRenal Per Dr. Fervenza, no site agreed to give cytoxan #NephJC |
| Eric Au @ericau @NephJC Hi Eric - nephrologist from Sydney #nsmc intern. No COI #nephjc |
 | Anika Lucas, MD, MTS @DrAnikaLucas Hi! 2nd year fellow .No COI #NephJC |
 | Diana Mahbod, MD, CPE, FASN, FNKF @DiMiRenalMD Hi! Diana here, private practice in Dallas. Love having the opportunity to connect with everyone and say current on how to be a good nephrologist out here in the community #nephJC https://t.co/anupclZ303 |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @felonaranjo @NephJC Welcome, Felipe! First time? #NephJC |
 | Samaya @TarSamMD Samaya from bcm no COI looking forward to today’s talk #NephJC #NSMC |
| Mohamed E. Elrggal @M_Elraggal A lot of familiar and new faces tonight, #NSMC on fire #NephJC |
| Nephrology Journal Club @NephJC #NephJC https://t.co/WYodhZysW6 |
| Alex Meraz @NephroGuy RT @NephJC: @Stones__ Although on #NephTwitter this past week, this has been happening too … #NephJC https://t.co/fuPMuuAHiI |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd MENTOR: Rituximab (vs Cyclosporine) for Membranous GN ca. 2019 from @NEJM 📌 Non-inferior in inducing complete/ partial remission of proteinuria at 12 months #Nephpearls #NephJC 👉🏼 https://t.co/0iLPPejnqM https://t.co/AufZ5Gn7Jv |
| Nephrology Journal Club @NephJC T0: To warm up, here is a great @Neph_Sim case for students, residents, and fellows to review PMN. #NephJC https://t.co/ifQkCRzAR1 … |
 | Enzo Vásquez @renal_enzo @NephJC Hi!, Enzo from National Institute of Cardiology @NefrologiaINC. Nephrology Residency. No COI. #NephJC |
| Sanjeev Nair @Nair_Sanj @poyanmehr @hswapnil @OttawaRenal And Ali comes in swinging from the get go. Absolutely agree with this. #NephJC |
| Krithika Mohan @krithicism RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Bhavnish @Buck1486 RT @edgarvlermamd: MENTOR: MENTOR: Rituximab (vs Cyclosporine) for Membranous GN ca. 2019 from @NEJM 📌 Non-inferior in inducing complete/ partial remission of proteinuria at 12 months #Nephpearls #NephJC 👉🏼 https://t.co/0iLPPejnqM https://t.co/AufZ5Gn7Jv |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD Author in the house! Welcome! #NephJC |
| Nephrology Journal Club @NephJC @Neph_Sim T0: #ICYMI here is the original manuscript first describing PMN in 1957 #NephJC https://t.co/GxVkH7TrHL https://t.co/jWwFgnIVsc |
| Alex Meraz @NephroGuy RT @LaurenceHBeckJ1: @poyanmehr @hswapnil @OttawaRenal Per Dr. Fervenza, no site agreed to give cytoxan #NephJC |
| R Lafayette @kidneybiz @poyanmehr @hswapnil @OttawaRenal Clearly not useless, but maybe not the best approach for all patients. #NephJC |
| Eric Au @ericau RT @edgarvlermamd: MENTOR: MENTOR: Rituximab (vs Cyclosporine) for Membranous GN ca. 2019 from @NEJM 📌 Non-inferior in inducing complete/ partial remission of proteinuria at 12 months #Nephpearls #NephJC 👉🏼 https://t.co/0iLPPejnqM https://t.co/AufZ5Gn7Jv |
| Nephrology Journal Club @NephJC @Neph_Sim T0: Some well-written reviews on PMN, spanning presentation, science, and Tx. #NephJC https://t.co/1d7XuEzx54 https://t.co/1cqHd4iA83 https://t.co/8UOA3d31KA |
 | Madhuri Ramakrishnan @madmagicdoc Hi NephJC fam, Madhuri here, second year fellow, being swept in the Rituximab tide, lurking, while finishing notes, no COI #NephJC |
| Vineet Behera @BeheraVineet RT @edgarvlermamd: MENTOR: MENTOR: Rituximab (vs Cyclosporine) for Membranous GN ca. 2019 from @NEJM 📌 Non-inferior in inducing complete/ partial remission of proteinuria at 12 months #Nephpearls #NephJC 👉🏼 https://t.co/0iLPPejnqM https://t.co/AufZ5Gn7Jv |
| Vanessa Lerma @VanessaLerma17 RT @NephJC: @Neph_Sim T0: @Neph_Sim T0: #ICYMI here is the original manuscript first describing PMN in 1957 #NephJC https://t.co/GxVkH7TrHL https://t.co/jWwFgnIVsc |
 | Rolando Claure, MD, FASN, FISN 🇧🇴 @RClaure_nefro @NephJC Hola 👋🏻 Rolando Claure , Nephrologist from 🇧🇴 no COIs #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @poyanmehr: @hswapnil @OttawaRenal Yet I think this trial would have been even more informative using cyclophosphamide as comparator. We all knew CNIs are “useless” in MN #NephJC |
| Nephrology Journal Club @NephJC @Neph_Sim T0: Can you describe what we see on path here (click on each image to view)? Paging path friends @Tiff_Caza + @ChangUCanSpare to help! #NephJC 📷EM (https://t.co/BmPSMJnyxr), silver stain (@arkanalabs) https://t.co/vapnvyoFuo |
| Mohamed E. Elrggal @M_Elraggal @SaynaNorouzi Hey Sayna, how do you do ? #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @poyanmehr Hi Ali, hope you are getting enough sleep #NephJC 👶 🙃 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @kidneybiz @poyanmehr @OttawaRenal Via @neilturn https://t.co/CePvAs3RGA #NephJC |
| Hassan Mahmoud @hassan_mohamud RT @NephJC: @Neph_Sim T0: @Neph_Sim T0: Some well-written reviews on PMN, spanning presentation, science, and Tx. #NephJC https://t.co/1d7XuEzx54 https://t.co/1cqHd4iA83 https://t.co/8UOA3d31KA |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: @Neph_Sim T0: @Neph_Sim T0: Can you describe what we see on path here (click on each image to view)? Paging path friends @Tiff_Caza + @ChangUCanSpare to help! #NephJC 📷EM (https://t.co/BmPSMJnyxr), silver stain (@arkanalabs) https://t.co/vapnvyoFuo |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: @Neph_Sim T0: @Neph_Sim T0: Some well-written reviews on PMN, spanning presentation, science, and Tx. #NephJC https://t.co/1d7XuEzx54 https://t.co/1cqHd4iA83 https://t.co/8UOA3d31KA |
| Vanessa Lerma @VanessaLerma17 RT @NephJC: @Neph_Sim T0: @Neph_Sim T0: Can you describe what we see on path here (click on each image to view)? Paging path friends @Tiff_Caza + @ChangUCanSpare to help! #NephJC 📷EM (https://t.co/BmPSMJnyxr), silver stain (@arkanalabs) https://t.co/vapnvyoFuo |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @HecmagsMD: Author in the house! Welcome! #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T0: T0: To warm up, here is a great @Neph_Sim case for students, residents, and fellows to review PMN. #NephJC https://t.co/ifQkCRzAR1 … |
| Hassan Mahmoud @hassan_mohamud RT @NephJC: @Neph_Sim T0: @Neph_Sim T0: #ICYMI here is the original manuscript first describing PMN in 1957 #NephJC https://t.co/GxVkH7TrHL https://t.co/jWwFgnIVsc |
| Nephrology Journal Club @NephJC T0: MENTOR comes 10 years after this landmark @NEJM study by @LaurenceHBeckJ1 reporting pathogenic antibodies against PLA2R in PMN patients, making it no longer “idiopathic” MN. #NephJC https://t.co/Xkt0abGn4l |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: Diagnosis and Treatment #KDIGOConnections from Dr David Bourne @arkanalabs #Nephpearls #NephJC https://t.co/dcnPKtiwvZ |
 | Prakash Gudsoorkar @gudnephron Prakash Gudsoorkar from @uofcincy . After a long hiatus I am back. @NephJC #NephJC. Read briefly about mentor. Recently succefully Rx a young male with Vitamin R in clinic. Pt is is complete remission. Excited about the MENTOR study results. https://t.co/wErGXOyvga |
| Nephrology Journal Club @NephJC @NEJM @LaurenceHBeckJ1 T0: Here is a nice review by @LaurenceHBeckJ1 and David Salant on the science and pathophysiology of PMN. #NephJC https://t.co/qcOsXjwWL0 |
| Nephrology Journal Club @NephJC @NEJM @LaurenceHBeckJ1 T0: For a disease with a pathogenic antibody, it makes sense that the optimal therapeutic approach would be to shut down production of that antibody. Rituximab does this by targeting B cells via CD20. #NephJC https://t.co/yNDb5GVEbx |
 | Fitsum Asnakech Tilahun MD @fitse_t @NephJC Fitsum from philly Fellow , no COI #NephJC Lurking while am on call https://t.co/tBlC4vm7pq |
 | Ivy Melgarejo @IvyM808 Hi, Ivy, 2nd yr renal fellow at @PitttRenal No COI #nephjc |
| Alex Meraz @NephroGuy RT @hswapnil: @kidneybiz @poyanmehr @OttawaRenal Via @neilturn https://t.co/CePvAs3RGA #NephJC |
 | Jon Klein PGY44 🇮🇱 @JonBKlein Jon Klein here. Mostly lurking. #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk T0: @Neph_Sim Case 35 #NephJC https://t.co/mBB2KygL1P https://t.co/bgywnwSfGv |
| Krithika Mohan @krithicism RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Diagnosis and Treatment #KDIGOConnections from Dr David Bourne @arkanalabs #Nephpearls #NephJC https://t.co/dcnPKtiwvZ |
| Nephrology Journal Club @NephJC @NEJM @LaurenceHBeckJ1 T0: It would also make sense to favor rituximab as a therapeutic option with fewer side effects than the gold standard, as studied in JASN (link below). #NephJC https://t.co/EnwsQ3kVFn https://t.co/4xpdT3MN41 |
| Vineet Behera @BeheraVineet RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Diagnosis and Treatment #KDIGOConnections from Dr David Bourne @arkanalabs #Nephpearls #NephJC https://t.co/dcnPKtiwvZ |
| Sanjeev Nair @Nair_Sanj @NephJC @Stones__ Meme needs to be upgraded to include Cyclophosphamide #NephJC |
| Alex Meraz @NephroGuy RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Diagnosis and Treatment #KDIGOConnections from Dr David Bourne @arkanalabs #Nephpearls #NephJC https://t.co/dcnPKtiwvZ |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: Antibody guided diagnostic and treatment algorithm ca. 2017 #Nephpearls #NephJC 👉🏼 https://t.co/hMij9bXGcq https://t.co/WLxhow5sMp |
| Nephrology Journal Club @NephJC @NEJM @LaurenceHBeckJ1 Tweet 10d T0: However, without compelling RCT data, KDIGO GN has not recommended rituximab as a first-line agent. What is your approach to PMN and why? #NephJC https://t.co/mSsMcyNcrR |
| Sayna Norouzi, MD, FASN @SaynaNorouzi RT @ssfarouk: T0: T0: @Neph_Sim Case 35 #NephJC https://t.co/mBB2KygL1P https://t.co/bgywnwSfGv |
| Tiffany Caza @Tiff_Caza RT @NephJC: @NEJM @LaurenceHBeckJ1 T0: @NEJM @LaurenceHBeckJ1 T0: For a disease with a pathogenic antibody, it makes sense that the optimal therapeutic approach would be to shut down production of that antibody. Rituximab does this by targeting B cells via CD20. #NephJC https://t.co/yNDb5GVEbx |
| Sayna Norouzi, MD, FASN @SaynaNorouzi RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Antibody guided diagnostic and treatment algorithm ca. 2017 #Nephpearls #NephJC 👉🏼 https://t.co/hMij9bXGcq https://t.co/WLxhow5sMp |
 | Ian McCoy, MD, MS @NephroNinja Ian from Palo Alto. Lurking tonight. No COI #NephJC |
| Ross Morton @signindoc #NephJC Riding the wave of confirmation bias so far. |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil Just for Ali 🤔#NephJC @poyanmehr |
| Nephrology Journal Club @NephJC @Nair_Sanj @Stones__ But there's a second meme ... :) #NephJC |
 | Natasha N. Dave @NatashaNDave Hey it’s Natasha from @NephBCM checking in #NephJC - no COI, will be lurking 😎 |
| Madhuri Ramakrishnan @madmagicdoc RT @NephJC: @NEJM @LaurenceHBeckJ1 T0: @NEJM @LaurenceHBeckJ1 T0: For a disease with a pathogenic antibody, it makes sense that the optimal therapeutic approach would be to shut down production of that antibody. Rituximab does this by targeting B cells via CD20. #NephJC https://t.co/yNDb5GVEbx |
| Krithika Mohan @krithicism RT @ssfarouk: T0: T0: @Neph_Sim Case 35 #NephJC https://t.co/mBB2KygL1P https://t.co/bgywnwSfGv |
| Madhuri Ramakrishnan @madmagicdoc RT @NephJC: @NEJM @LaurenceHBeckJ1 T0: @NEJM @LaurenceHBeckJ1 T0: It would also make sense to favor rituximab as a therapeutic option with fewer side effects than the gold standard, as studied in JASN (link below). #NephJC https://t.co/EnwsQ3kVFn https://t.co/4xpdT3MN41 |
| Madhuri Ramakrishnan @madmagicdoc RT @NephJC: @NEJM @LaurenceHBeckJ1 Tweet 10d T0: However, without compelling RCT data, KDIGO GN has not recommended rituximab as a first-line agent. What is your approach to PMN and why? #NephJC https://t.co/mSsMcyNcrR |
| Vineet Behera @BeheraVineet RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Antibody guided diagnostic and treatment algorithm ca. 2017 #Nephpearls #NephJC 👉🏼 https://t.co/hMij9bXGcq https://t.co/WLxhow5sMp |
| Madhuri Ramakrishnan @madmagicdoc RT @NephJC: T0: T0: MENTOR comes 10 years after this landmark @NEJM study by @LaurenceHBeckJ1 reporting pathogenic antibodies against PLA2R in PMN patients, making it no longer “idiopathic” MN. #NephJC https://t.co/Xkt0abGn4l |
| Timothy Yau @Maximal_Change I was a fellow at @Rush_Nephrology when this came out. Remember a case presented and everyone including @NephRodby and @TWhittier_RUSH started talking about Heymann Nephritis and I had no idea what any of it meant. #NephJC |
 | Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn Mitchell Lunn, Assistant Prof @StanfordMed. No COI. Lurking today. #nephjc |
| Mohamed E. Elrggal @M_Elraggal @NephJC @NEJM @LaurenceHBeckJ1 why not plasma cells ? #NephJC |
| Nephrology Journal Club @NephJC RT @Maximal_Change: I was a fellow at @Rush_Nephrology when this came out. Remember a case presented and everyone including @NephRodby and @TWhittier_RUSH started talking about Heymann Nephritis and I had no idea what any of it meant. #NephJC |
| Natasha N. Dave @NatashaNDave RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Alex Meraz @NephroGuy RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Antibody guided diagnostic and treatment algorithm ca. 2017 #Nephpearls #NephJC 👉🏼 https://t.co/hMij9bXGcq https://t.co/WLxhow5sMp |
| Ian McCoy, MD, MS @NephroNinja RT @NephJC: @Stones__ Although on #NephTwitter this past week, this has been happening too … #NephJC https://t.co/fuPMuuAHiI |
| Laurence H Beck, Jr @LaurenceHBeckJ1 Oops forgot #NephJC |
| Nephrology Journal Club @NephJC @M_Elraggal @NEJM @LaurenceHBeckJ1 No CD20 #NephJC |
| Natasha N. Dave @NatashaNDave RT @NephJC: @Stones__ Although on #NephTwitter this past week, this has been happening too … #NephJC https://t.co/fuPMuuAHiI |
| Mohamed E. Elrggal @M_Elraggal @SaynaNorouzi 3 am now Zzzzz, can't miss MENTOR though #NephJC |
| R Lafayette @kidneybiz @NephJC @NEJM @LaurenceHBeckJ1 OF course KDIGO just met and opinions may be changing. WE may also soon learn about combinations of agents such as cytoxan-cyclosporine or rituximab-cysclosporine. #nephjc |
| Nephrology Journal Club @NephJC Any comments on how you currently treat PMN in clinic? #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @Renaltubules STARMEN trial is including an arm with methylprednisolone-cyclophosphamide but vs tacrolimus-rituximab. https://t.co/yAlvTMpJa7 #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: Proposed categorization ca. 2019 from @goKDIGO @Kidney_Int #Nephpearls #NephJC 👉🏼 https://t.co/LuNew12UwI https://t.co/iHWyJDbIu5 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC @NEJM @LaurenceHBeckJ1 Cyclophosphamide if persistent high grade Proteinuria (modified Ponticelli) Refer to GN clinic ASAP though at @ottawarenal for @toddfairhead & @cchesketh to take over #NephJC |
| Nephrology Journal Club @NephJC @NEJM @LaurenceHBeckJ1 T0: For those of you who use CNIs for PMN, why did you choose this drug class over cyclophosphamide or rituximab, and which CNI do you prescribe? #NephJC |
| Mohamed E. Elrggal @M_Elraggal @NephJC @NEJM @LaurenceHBeckJ1 I mean why not target the plasma cells, the Antibody producing cells #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @NephJC 1. RTX 2. TAC 3. CYC/PRED 4. ACTH #NephJC |
| Natalie McCall @_NatalieMcCall If persistent high grade proteinuria, using ponticelli protocol #nephjc |
| Alex Meraz @NephroGuy @M_Elraggal @NephJC @NEJM @LaurenceHBeckJ1 Plasma cell directed therapy may work 🤔 #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @kidneybiz @NephJC @NEJM @LaurenceHBeckJ1 @kidneybiz: are there medications in the R+D pipeline for MN? #nephJC |
| Nephrology Journal Club @NephJC @NEJM @LaurenceHBeckJ1 T0: Earlier today, we asked you about your pre-MENTOR approach to treating PMN. The majority of 126 of you chose Ponticelli. We will poll again later during this chat. #NephJC https://t.co/ld2rWFwLH5 |
| Alex Meraz @NephroGuy @NephJC @NEJM @LaurenceHBeckJ1 Let’s see the update #NephJC |
| Natasha N. Dave @NatashaNDave RT @NephJC: T0: T0: MENTOR comes 10 years after this landmark @NEJM study by @LaurenceHBeckJ1 reporting pathogenic antibodies against PLA2R in PMN patients, making it no longer “idiopathic” MN. #NephJC https://t.co/Xkt0abGn4l |
| Raymond Hsu @DrRaymondHsu @NephJC @NEJM @LaurenceHBeckJ1 because CYC + pred alternating months is so painful for the patient #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: This schematic presents a categorization of primary MN into subgroups on the basis of association with the two known antigens, PLA2R and THSD7A ca. 2017 from @JASN_News #Nephpearls #NephJC 👉🏼 https://t.co/I9Meoi8ikK https://t.co/WGoWkpdjap |
 | Stanley Crittenden, MD, FASN @SCrittendenMD Hi all! Stanley. Long time lurker. Checking in from LA. @Caremore Nephrology director #nephjc |
| Nephrology Journal Club @NephJC RT @LaurenceHBeckJ1: @NephJC 1. RTX 2. TAC 3. CYC/PRED 4. ACTH #NephJC |
 | Joel M. Topf, MD FACP @kidney_boy Joel Topf from 30,000 feet on my way to see Trump’s big dialysis announcement tomorrow. #NephJC |
| Nephrology Journal Club @NephJC RT @HecmagsMD: @Renaltubules STARMEN trial is including an arm with methylprednisolone-cyclophosphamide but vs tacrolimus-rituximab. https://t.co/yAlvTMpJa7 #NephJC |
| Vineet Behera @BeheraVineet How many of you were actually using rituximab as firstline therapy in clinical practice in primary MN ? #nephjc @hswapnil @rheault_m @edgarvlermamd @Nair_Sanj |
 | fernando fervenza @fervenzafernan1 #nephJC |
| Stella Shin, MD @BabyBeanDoc @NephJC @NEJM @LaurenceHBeckJ1 No consistent approach here, as MN is exceedingly rare in children, but most start with a trial of steroids since children with nephrotic syndrome are presumed to have MCD until proven otherwise. After that, all bets are off. #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @fervenzafernan1 Welcome Fernando!!! #NephJC |
| Nephrology Journal Club @NephJC Great discussion, tweeps! We will move on to T1 (Methods) shortly. #NephJC https://t.co/9hCYZKYzIf |
| Ross Morton @signindoc #NephJC Cyclophosphamide and prednisone have been my go to for many years. |
| Timothy Yau @Maximal_Change @NephJC Depends on degree of proteinuria, severity of nephrotic syndrome, and patient preference. If severe I still opt for cytoxan and steroids. CNIs can also be considered if pt preference. Rituxan has been third line before mentor. I refuse to use acthar #NephJC |
 | Andrew Donati @ADonatiMD Andrew-Just finished IM residency at UT Health San Antonio. Currently applying to Nephology fellowship. #NephJC |
| Rolando Claure, MD, FASN, FISN 🇧🇴 @RClaure_nefro @NephJC Usually we used a modified Ponticelli protocol with I.V. Cyclosphosphamide #NephJC |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah Author in the house!! #nephJC |
| Nathaniel Reisinger @nephrothaniel RT @LaurenceHBeckJ1: @NephJC 1. RTX 2. TAC 3. CYC/PRED 4. ACTH #NephJC |
| Nephrology Journal Club @NephJC Welcome, Dr. Fervenza! Author in the house! #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @kidney_boy @kidney_boy : I will see you tomorrow in DC but the announcement is beyond #dialysis #NephJC |
| Poyan Mehr @poyanmehr RT @hswapnil: @kidneybiz @poyanmehr @OttawaRenal Via @neilturn https://t.co/CePvAs3RGA #NephJC |
| Nephrology Journal Club @NephJC T1: Now let’s talk Methods. The Research Question: Is rituximab noninferior to cyclosporine in inducing and maintaining remission of proteinuria for up to 24 months in PMN patients? #NephJC https://t.co/kjdTPdQL5o |
 | nirajan mainali @NirajanMainali @NephJC Nirajan mainali from Nepal. Currently, a renal pathology fellow at University of Alberta,Canada. #NephJC |
| Tiffany Caza @Tiff_Caza @NephJC Any new fellows here for the first time, since it's the first chat of the academic year? If so, welcome to #NephJC ! |
| Timothy Yau @Maximal_Change @ADonatiMD Welcome!!!#NephJC |
| Michelle Rheault @rheault_m @NephJC There is an @CureGN manuscript close to publication that reports current practice patterns for treatment of MN in our cohort of >350 pts. 🤐 #NephJC |
| Nephrology Journal Club @NephJC T1: Trial Design The MENTOR study was an investigator-initiated, open-label, multicenter randomized noninferiority trial, with a noninferiority margin set at 15%. #NephJC https://t.co/wwJTUTz3rf |
| Verner Venegas @Vernisartan RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: This schematic presents a categorization of primary MN into subgroups on the basis of association with the two known antigens, PLA2R and THSD7A ca. 2017 from @JASN_News #Nephpearls #NephJC 👉🏼 https://t.co/I9Meoi8ikK https://t.co/WGoWkpdjap |
| Alex Meraz @NephroGuy @NephJC In Mexico we use IV steroids alternated with IV CFM. Not a lot of patients has the option of Rituximab because it is super expensive #NephJC |
| Tiffany Caza @Tiff_Caza RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Antibody guided diagnostic and treatment algorithm ca. 2017 #Nephpearls #NephJC 👉🏼 https://t.co/hMij9bXGcq https://t.co/WLxhow5sMp |
| Tiffany Caza @Tiff_Caza RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Diagnosis and Treatment #KDIGOConnections from Dr David Bourne @arkanalabs #Nephpearls #NephJC https://t.co/dcnPKtiwvZ |
| Sanjeev Nair @Nair_Sanj @BeheraVineet @hswapnil @rheault_m @edgarvlermamd Not me. And u go by the responses to my poll after #MENTOR not many others in India either. https://t.co/QpM7OZ5zW7 #NephJC |
| Prakash Gudsoorkar @gudnephron @NephJC #NephJC Have used Cylophos with good results previously. But with my recent experience with RTx i have become a prisoner of my own experience. Pt had 24 g protein , PLA2RAb +, Stain on KBx + for PLA2RAg. 9 months follow up UPCR 0.3. |
| Ross Morton @signindoc #NephJC Biggest question is why was cyclosporine the comparator? |
| Mohamed E. Elrggal @M_Elraggal @NephJC @NEJM @LaurenceHBeckJ1 CNI (usually cyclosporine) only in young patients, not willing to take the risk #NephJC |
| Nephrology Journal Club @NephJC T1: For considerations in interpreting noninferiority trials, see the linked NEJM review and excellent post by @manasib33 . #NephJC https://t.co/RWUYbtQ4mX https://t.co/Vm8F8oLgAH |
| Jon Klein PGY44 🇮🇱 @JonBKlein Cytoxan and steroids until about a year ago until Dawn Caster turned me into a ritux acolyte #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: Now let’s talk Methods. The Research Question: Is rituximab noninferior to cyclosporine in inducing and maintaining remission of proteinuria for up to 24 months in PMN patients? #NephJC https://t.co/kjdTPdQL5o |
| Verner Venegas @Vernisartan RT @NephJC: T1: T1: For considerations in interpreting noninferiority trials, see the linked NEJM review and excellent post by @manasib33 . #NephJC https://t.co/RWUYbtQ4mX https://t.co/Vm8F8oLgAH |
| Nephrology Journal Club @NephJC @manasib33 T1: For more on setting noninferiority margins, see this linked review. Was the 15% in MENTOR sound and reasonable? #NephJC https://t.co/pm3uMY9Ddn |
| Vineet Behera @BeheraVineet @NephJC 1. Rituximab 2. Steroids + cyclophosphamide 3. Tacrolimus #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC When prescribing CNIs how do you incorporate the cancer risk considering some patients may be transplanted? Furthermore how do incorporate the neurotoxicity side effects as well? #nephJC |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn @DrRaymondHsu @NephJC @NEJM @LaurenceHBeckJ1 And complicated. I have found that people forget to switch monthly. #nephjc |
| Tiffany Caza @Tiff_Caza @rheault_m @NephJC @CureGn Awesome! Please share your results when it comes out 😁. #nephjc |
| Michelle Rheault @rheault_m @BabyBeanDoc @NephJC @NEJM @LaurenceHBeckJ1 Yes, most children with membranous start with 6 weeks of steroids before they even have a biopsy diagnosis of MN. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephJC How was the 15% margin decided @kidneybiz and @fervenzafernan1 ? #NephJC |
| Mohamed E. Elrggal @M_Elraggal @BeheraVineet @hswapnil @rheault_m @edgarvlermamd @Nair_Sanj not me #NephJC #cost |
| Eric Au @ericau RT @rheault_m: @NephJC There is an @CureGN manuscript close to publication that reports current practice patterns for treatment of MN in our cohort of >350 pts. 🤐 #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk May have missed this - where did the 15% margin come from? #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @JonBKlein What was the reason for the change? #nephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: For considerations in interpreting noninferiority trials, see the linked NEJM review and excellent post by @manasib33 . #NephJC https://t.co/RWUYbtQ4mX https://t.co/Vm8F8oLgAH |
 | Dr. Guillén 🇲🇽 @drguillenvargas RT @NephJC: T0: T0: To warm up, here is a great @Neph_Sim case for students, residents, and fellows to review PMN. #NephJC https://t.co/ifQkCRzAR1 … |
| Alex Meraz @NephroGuy @fervenzafernan1 @LaurenceHBeckJ1 Excited for tomorrow’s @LGlomcon talk in Spanish!! #NephJC |
| Ross Morton @signindoc #NephJC Pardon my ignorance, but is a non-inferiority study a gamble to say if we are not better, maybe we can be close to 15% less effective and it is as effective? |
 | 🇬🇹José Alejandro J.N.🇬🇹 @joanava_nefro RT @NephJC: T1: T1: Trial Design The MENTOR study was an investigator-initiated, open-label, multicenter randomized noninferiority trial, with a noninferiority margin set at 15%. #NephJC https://t.co/wwJTUTz3rf |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil #NephJC |
| Nephrology Journal Club @NephJC Would @fervenzafernan1 like to comment on how 15% margin was derived? #NephJC |
| Michelle Rheault @rheault_m @ADonatiMD If you need a #NephJC letter of reference, just let us know. 😉 |
| Mohamed E. Elrggal @M_Elraggal @fervenzafernan1 @LaurenceHBeckJ1 add #NephJC to all your tweets |
| Anna Burgner MD MEHP @anna_burgner This!!!👇👇👇👇#NephJC |
| Nephrology Journal Club @NephJC RT @ssfarouk: May have missed this - where did the 15% margin come from? #NephJC |
| Alex Meraz @NephroGuy RT @NephJC: T1: T1: For considerations in interpreting noninferiority trials, see the linked NEJM review and excellent post by @manasib33 . #NephJC https://t.co/RWUYbtQ4mX https://t.co/Vm8F8oLgAH |
 | Bill Whittier @TWhittier_RUSH RT @Maximal_Change: I was a fellow at @Rush_Nephrology when this came out. Remember a case presented and everyone including @NephRodby and @TWhittier_RUSH started talking about Heymann Nephritis and I had no idea what any of it meant. #NephJC |
| Rolando Claure, MD, FASN, FISN 🇧🇴 @RClaure_nefro RT @NephJC: T1: T1: Trial Design The MENTOR study was an investigator-initiated, open-label, multicenter randomized noninferiority trial, with a noninferiority margin set at 15%. #NephJC https://t.co/wwJTUTz3rf |
| Mohamed E. Elrggal @M_Elraggal Author in house #Nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @LaurenceHBeckJ1 @NephJC Curious why ACTH? Seems to lack evidence...no RCTs and $39,000 per vial #NephJC |
| Nephrology Journal Club @NephJC T1: Here is the overall trial design (Fig S1). Each arm had 65 participants, providing at least 80% power to detect noninferiority at the preset 15% margin. Any comments or concerns on sample size and design? #NephJC https://t.co/7T6RHlEWNH |
| Vineet Behera @BeheraVineet Visual abstract - original ponticelli regimen |
| Poyan Mehr @poyanmehr @hswapnil And I’m a fervent believer/supporter of MENTOR trials. Way due and cudos to the investors for pulling this off. Our patients are so much better off now. Yet, dang, CNI. Really? #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T1: T1: Here is the overall trial design (Fig S1). Each arm had 65 participants, providing at least 80% power to detect noninferiority at the preset 15% margin. Any comments or concerns on sample size and design? #NephJC https://t.co/7T6RHlEWNH |
 | Shina_Menon @menonshina @rheault_m @BabyBeanDoc @NephJC @NEJM @LaurenceHBeckJ1 True. Post biopsy, our approach has been rituximab or tacrolimus with tapering steroids #NephJC |
| Nephrology Journal Club @NephJC T1: Any comments on the inclusion/exclusion criteria (details in supplement)? Broadly speaking, participants were adults with biopsy-proven PMN + > 5 g/day proteinuria on ACEI/ARB, without active infection, pregnancy, or diabetes. #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @hswapnil @NephJC I still believe it has immunosuppressive effects beyond those of steroids. Was able to decrease aPLA2R in a few. #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk @NephJC Nice, first figure shared from the paper fresh from the supplement! #NephJC @hswapnil @NephJC_Podcast |
| Sayna Norouzi, MD, FASN @SaynaNorouzi @janewitwong @umnmedresidency Hi! Welcome to #nephjc |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: Treatment regimens PRE-MENTOR #Nephpearls #NephJC https://t.co/deVFJis603 |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @ssfarouk @NephJC @hswapnil @NephJC_Podcast Supplement is definitely worth looking at! #NephJC |
| Alex Meraz @NephroGuy @poyanmehr @hswapnil This is a question for professor @fervenzafernan1 #nephjc |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @signindoc Also, I think KDIGO GN guidelines recommend cyclosporine as first line therapy… #NephJC |
| Mohamed E. Elrggal @M_Elraggal RT @rheault_m: @NephJC There is an @CureGN manuscript close to publication that reports current practice patterns for treatment of MN in our cohort of >350 pts. 🤐 #NephJC |
| Nephrology Journal Club @NephJC T1: Intervention Rituximab arm: 1000 mg IV on days 1 and 15 (donated by Genentech) Cyclosporine arm: 3.5 mg per kg per day every 12 hours with dose adjustment to target trough and for bump in serum creatinine #NephJC |
| Vipin Varghese @vipvargh RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Treatment regimens PRE-MENTOR #Nephpearls #NephJC https://t.co/deVFJis603 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @ssfarouk @NephJC @NephJC_Podcast #NephJC https://t.co/Sko8RvO4Xz |
| Samira Farouk, MD, MSCR @ssfarouk @LaurenceHBeckJ1 @NephJC @hswapnil @NephJC_Podcast Supplement = (secret) gold! #NephJC |
 | Juan Monkey @juandiaznz RT @NephJC: Check out the background and summary of the MENTOR study: https://t.co/pKIk6Ebtsb Thoroughly enjoyed geeking out about PMN and rituximab to write it! #NephJC |
| fernando fervenza @fervenzafernan1 RT @edgarvlermamd: MENTOR: MENTOR: Rituximab (vs Cyclosporine) for Membranous GN ca. 2019 from @NEJM 📌 Non-inferior in inducing complete/ partial remission of proteinuria at 12 months #Nephpearls #NephJC 👉🏼 https://t.co/0iLPPejnqM https://t.co/AufZ5Gn7Jv |
| Poyan Mehr @poyanmehr @Maximal_Change @Rush_Nephrology @NephRodby @TWhittier_RUSH This makes you look super young and @TWhittier_RUSH like an old dude 😂 #NephJC |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn @anna_burgner How many times can I ❤️ this? #nephjc @kidneybiz |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @CristhianMuM Good question! #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @LaurenceHBeckJ1 @hswapnil @NephJC Without the CNI side effects, correct? #nephJC |
| Stella Shin, MD @BabyBeanDoc @menonshina @rheault_m @NephJC @NEJM @LaurenceHBeckJ1 Same here. Currently dealing with a challenging case that has not responded to anything but steroids (interestingly enough)...but can’t keep ‘em on steroids forever! #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @ssfarouk @LaurenceHBeckJ1 @NephJC @NephJC_Podcast In this case, tons of data Treasure trove of tables and figures #NephJC |
| Nephrology Journal Club @NephJC T1: Timing Randomization, then observation for 6 months. Partial responders continued therapy up to month 12 while non-responders did not continue treatment. Different from GEMRITUX timeline! All were observed until month 24. #NephJC |
| Nephrology Journal Club @NephJC T1: Primary endpoint = composite of complete or partial remission of proteinuria at 24 months. Complete remission: ≤ 0.3 g/24 hours proteinuria + serum albumin ≥ 3.5 g/dL Partial: ≥ 50% reduction in proteinuria (0.3 and 3.5 g/day). #NephJC |
 | Aditya Pawar @renalranger @fervenzafernan1 @rheault_m Hi! Please type #nephjc at the end of each tweet and that will get you in. |
| Enzo Vásquez @renal_enzo @hswapnil @poyanmehr I have a dream. someday: RTX vs cyclophosphamide. #NephJC |
| Nephrology Journal Club @NephJC T1: Secondary endpoints were many, including different time points, relapse, anti-PLA2R levels over time, quality of life, CrCl, ESKD, adverse events. #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @NephJC Still waiting for a clinical MN trial to incorporate aPLA2R in the inclusion criteria (eg, stable or rising) or to assess path through clinical trial (eg, treatment failure if <25% drop in aPLA2R)! This could exclude patients already going into spontaneous remission #NephJC |
| Michelle Rheault @rheault_m @fervenzafernan1 Go to https://t.co/4LAYUUK5KL, log in to your twitter account, and type in #NephJC. You will be able to see all of the tweets. Make sure to add the hashtag so everyone else can see your tweets. |
| Nephrology Journal Club @NephJC RT @LaurenceHBeckJ1: @NephJC Still waiting for a clinical MN trial to incorporate aPLA2R in the inclusion criteria (eg, stable or rising) or to assess path through clinical trial (eg, treatment failure if <25% drop in aPLA2R)! This could exclude patients already going into spontaneous remission #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk RT @LaurenceHBeckJ1: @NephJC Still waiting for a clinical MN trial to incorporate aPLA2R in the inclusion criteria (eg, stable or rising) or to assess path through clinical trial (eg, treatment failure if <25% drop in aPLA2R)! This could exclude patients already going into spontaneous remission #NephJC |
| Nephrology Journal Club @NephJC @christhero10 @hswapnil @poyanmehr your dream will come true #nephjc |
| Verner Venegas @Vernisartan @NephJC or without SLE, Medication, Malignancies. And NO History of Resistance to Cyclosporine or Tacrolimus. #NephJC |
| Timothy Yau @Maximal_Change @NephJC Kinda wished they bumped up the proteinuria inclusion. 5 grams is in the gray zone for aggressive treatment #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @CristhianMuM Very good question but aren't the majority of the patients MN white? #nephJC |
| Vineet Behera @BeheraVineet Why was cyclosporin used as comparison arm? Why not 1. Mod ponticelli or 2. Tacrolimus @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy #nephjc |
| fernando fervenza @fervenzafernan1 Hi #nephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @gratefull080504 @CristhianMuM Not in China! #NephJC |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah #DreamRCT @UKidney #NephJC |
| Tiffany Caza @Tiff_Caza Great review of trial design and statistics by @manasib33 |
| Alex Meraz @NephroGuy @hswapnil @ssfarouk @LaurenceHBeckJ1 @NephJC @NephJC_Podcast Like the fact that double RAAS blockad was used in some patients #Nephjc |
| Nephrology Journal Club @NephJC T1: Please note that the anti-PLA2R ELISA used in MENTOR differs from the commercial assay most clinicians would use, and values would be different. Any comments, @LaurenceHBeckJ1? #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @NephJC: T1: T1: Here is the overall trial design (Fig S1). Each arm had 65 participants, providing at least 80% power to detect noninferiority at the preset 15% margin. Any comments or concerns on sample size and design? #NephJC https://t.co/7T6RHlEWNH |
| Anna Burgner MD MEHP @anna_burgner @christhero10 @hswapnil @poyanmehr Yes!! This is the trial we need!!#nephjc |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @NephJC Very good point. #NephJC |
| Nephrology Journal Club @NephJC T1: Any additional comments on trial design before we move on to Results? #NephJC |
| Verner Venegas @Vernisartan RT @christhero10: @hswapnil @poyanmehr I have a dream. someday: @hswapnil @poyanmehr I have a dream. someday: RTX vs cyclophosphamide. #NephJC |
| 🇬🇹José Alejandro J.N.🇬🇹 @joanava_nefro RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Treatment regimens PRE-MENTOR #Nephpearls #NephJC https://t.co/deVFJis603 |
 | Luis Enrique Alvarez @LuisAlvarezRa Hi everyone!! Luis Alvarez from Mexico City. No COI. #NephJC. LaRazaKIdneyTeam |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC Perhaps I missed but I did not see a formal #PROM If it was not included, it would be great to add in for future trials #nephJC |
| Nephrology Journal Club @NephJC RT @fervenzafernan1: Hi #nephJC |
| Tiffany Caza @Tiff_Caza RT @LaurenceHBeckJ1: @NephJC Still waiting for a clinical MN trial to incorporate aPLA2R in the inclusion criteria (eg, stable or rising) or to assess path through clinical trial (eg, treatment failure if <25% drop in aPLA2R)! This could exclude patients already going into spontaneous remission #NephJC |
| Timothy Yau @Maximal_Change @christhero10 @hswapnil @poyanmehr Won’t happen. Beck said no centers would agree to use cytoxan as comparator arm #NephJC |
| Samira Farouk, MD, MSCR @ssfarouk @gratefull080504 @CristhianMuM Resurgence of PMN in AA in Chicago #NephJC https://t.co/omKEln0wb8 |
| Michelle Rheault @rheault_m @NephJC Was this a label enabling trial? Will Rituximab get a membranous indication? #NephJC @fervenzafernan1 |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @LaurenceHBeckJ1 @CristhianMuM Thanks for the correction I am too US centered #nephJC |
| Nephrology Journal Club @NephJC RT @M_Elraggal: @fervenzafernan1 @LaurenceHBeckJ1 add #NephJC to all your tweets |
| Janewit Wongboonsin, MD, MS @janewitwong Does the run-in seems reasonable to most practicing nephrologist? #NephJC |
| Raymond Hsu @DrRaymondHsu @NephJC For T1 cyclosporine arm protocol: not sure most in clinical practice would have tapered to off over 2 months after CR -- quicker than usual care? #NephJC |
| Nephrology Journal Club @NephJC RT @gratefull080504: @NephJC When prescribing CNIs how do you incorporate the cancer risk considering some patients may be transplanted? Furthermore how do incorporate the neurotoxicity side effects as well? #nephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @ssfarouk @CristhianMuM Thanks for sharing #nephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz Best of #NephJc Author in 🏡 |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @CristhianMuM Excellent question… PMN very common in Whites, but as you know, a lot of our patients (including a lot of us) are a mix, so I think is definitively worth looking at ethnicities. #nephJC. |
| Pablo Garcia @PabloGarciaMD @ssfarouk @hswapnil @NephJC @kidneybiz @fervenzafernan1 #Nephjc this is the explanation at the NEJM appendix https://t.co/wa5NOMMyMj |
| Rolando Claure, MD, FASN, FISN 🇧🇴 @RClaure_nefro @NephJC I like the approach it is similar of this algorithm 👇🏻#NephJC https://t.co/ylw1zOhosx |
 | Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 Marvin Gonzalez. Senior lecturer at UNAN-Leon. NO COI. Lurking today. #NephJC #NSMCIntern2019 |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil #NephJC |
| L. Parker Gregg @LParkerGregg1 RT @hswapnil: #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @PabloGarciaMD: @ssfarouk @hswapnil @NephJC @kidneybiz @fervenzafernan1 #Nephjc this is the explanation at the NEJM appendix https://t.co/wa5NOMMyMj |
| Timothy Yau @Maximal_Change @Furqi @christhero10 @hswapnil @poyanmehr Not sure maybe @LaurenceHBeckJ1 can tell us why enrollling centers were resistant? #NephJC |
| Michelle Rheault @rheault_m @janewitwong Yes, more and more finding that run in period important to ensure all starting from the same place. #NephJC Standard of care RAS blockade not always standard of care. |
| Nephrology Journal Club @NephJC T2: We’ve had the amuse-bouche and some starter plates for tonight’s chat. Now for the main course … Results. #NephJC https://t.co/dWsH14cYjX |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD #Nephjc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @PabloGarciaMD @ssfarouk @NephJC @kidneybiz @fervenzafernan1 That’s a very reasonable explanation IMO Thanks for picking up #NephJC |
| Vineet Behera @BeheraVineet RT @RClaure_nefro: @NephJC I like the approach it is similar of this algorithm 👇🏻#NephJC https://t.co/ylw1zOhosx |
| Sanjeev Nair @Nair_Sanj @NephJC @NEJM @LaurenceHBeckJ1 Cyclophosphamide..cost. And i feel the toxicity might be overstated. Will be studying this along with @raja_1980 But among CNIs Tac > CsA #NephJC |
| Ross Morton @signindoc RT @hswapnil: #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Controlled Trial of Methylprednisolone and Chlorambucil in Idiopathic Membranous Nephropathy ca. 1984 from @NEJM #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/KcY2ZcuLJK https://t.co/wSoSeqRAJx |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD #nephjc |
| Nephrology Journal Club @NephJC T2: 130 participants were enrolled, with 65 in each arm. Below are baseline characteristics of the participants: mostly middle-aged, majority male, with heavy proteinuria and relatively high creatinine clearance. #NephJC https://t.co/qWSlgYecsb |
| Samira Farouk, MD, MSCR @ssfarouk @hswapnil @PabloGarciaMD @NephJC @kidneybiz @fervenzafernan1 Supplement FTW #NephJC |
| Verner Venegas @Vernisartan RT @edgarvlermamd: Controlled Trial of Methylprednisolone and Chlorambucil in Idiopathic Membranous Nephropathy ca. 1984 from @NEJM #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/KcY2ZcuLJK https://t.co/wSoSeqRAJx |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @Maximal_Change @Furqi @christhero10 @hswapnil @poyanmehr Was only part of initial interviews by study, but most US and Canadian centers feel more comfortable treating with CNI. Too many SAE with alkylating agents. #NephJC |
| R Lafayette @kidneybiz @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy No superiority of tacrolimus vs . cyclosporine, and most North American docs felt they and patients would not accept comparison treatment with cyclophosphamide. Dan's (Cattran)experience with cyclosporine pretty compelling for reasonably effective, safe agent to use. #nephJC |
| Sanjeev Nair @Nair_Sanj RT @NephJC: Before the #MENTOR study was published, what was your approach for treating primary membranous patients with persistent nephrotic-range proteinuria already on ACEI/ARB and supportive therapy? #NephJC |
| Vineet Behera @BeheraVineet #NephJC |
| R Lafayette @kidneybiz @fervenzafernan1 Good evening Fernando! #nephJC |
| Nephrology Journal Club @NephJC T2: Figure 1 is the Grade A Hokkaido uni, the Tomahawk ribeye, “the meat” of the paper. This chat host might be a little hungry. #NephJC https://t.co/PK8PoC9Ed3 |
| Alex Meraz @NephroGuy @Maximal_Change @christhero10 @hswapnil @poyanmehr #RICYCLO May give us some light https://t.co/XTuqSf2ufN #NephJC |
| Timothy Yau @Maximal_Change @LaurenceHBeckJ1 @Furqi @christhero10 @hswapnil @poyanmehr Thx for clarification! #NephJC |
 | Jung Hoon Son, M.D. @junghoon_sonMD RT @NephJC: Here we have another fantastic visual abstract created by @Stones__ #NephJC https://t.co/FoCT0ONvr4 |
| Sanjeev Nair @Nair_Sanj RT @signindoc: #NephJC Biggest question is why was cyclosporine the comparator? |
| Nephrology Journal Club @NephJC T2: Back to Figure 1 Compared to cyclosporine, Rituximab was noninferior at 12 months and superior at 24 months in achieving the composite remission outcome. #NephJC https://t.co/r4Q09EhgeC |
| fernando fervenza @fervenzafernan1 RT @kidneybiz: @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy No superiority of tacrolimus vs . cyclosporine, and most North American docs felt they and patients would not accept comparison treatment with cyclophosphamide. Dan's (Cattran)experience with cyclosporine pretty compelling for reasonably effective, safe agent to use. #nephJC |
| Mohamed E. Elrggal @M_Elraggal @NephJC what was the target trough ? #NephJC |
| Poyan Mehr @poyanmehr @Maximal_Change @christhero10 @hswapnil Did Dr @fervenzafernan1 pick sites, who’s practices are not representative of what most nephrologist and centers seem to use? I haven’t surveyed that but yet have to say that only a minority of nephrologists i know would use CNI as primary tx in severe MN #NephJC |
| Timothy Yau @Maximal_Change @cnavadr @LaurenceHBeckJ1 @NephJC I think @kidneydoc101 is a big fan of this approach iirc #NephJC |
| Salem Almaani @SalemAlmaani @edgarvlermamd @NEJM @CristhianMuM @landmark_neph I am not sure I would use a gram of solumedrol for anything #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC I am really surpirised that there is no discussion about quality of life in these studies Perhaps I am missing the conversation |
| Nephrology Journal Club @NephJC T2: Figure S8 shows what happens to proteinuria over time in the two treatment arms. Note the y-axis is on a log scale. #NephJC https://t.co/JqxyobV0zB |
| Tiffany Caza @Tiff_Caza RT @NephJC: T2: T2: Back to Figure 1 Compared to cyclosporine, Rituximab was noninferior at 12 months and superior at 24 months in achieving the composite remission outcome. #NephJC https://t.co/r4Q09EhgeC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy ca. 2019 #Nephpearls #NephJC #VisualAbstract by @CristhianMuM 👉🏼 https://t.co/0iLPPejnqM https://t.co/YIYwgjI0ve |
| Vineet Behera @BeheraVineet RT @NephroGuy: @Maximal_Change @christhero10 @hswapnil @poyanmehr #RICYCLO May give us some light https://t.co/XTuqSf2ufN #NephJC |
| Timothy Yau @Maximal_Change @NephJC Ur such a foodie Jennie #NephJC |
| fernando fervenza @fervenzafernan1 @kidneybiz Larry Beck told me to join by I am just learning #nephjc |
 | Katherine Twombley @Kftwom @rheault_m Michelle is a great voice for us Peds nephs. Totally agree adolescents should have been included! #NephJC |
| Nephrology Journal Club @NephJC @gratefull080504 There is! no difference seen #NephJC |
| Verner Venegas @Vernisartan RT @edgarvlermamd: Rituximab or Cyclosporine in the Treatment of Membranous Nephropathy ca. 2019 #Nephpearls #NephJC #VisualAbstract by @CristhianMuM 👉🏼 https://t.co/0iLPPejnqM https://t.co/YIYwgjI0ve |
| Nephrology Journal Club @NephJC T2: Figure S10 shows what happens to anti-PLA2R levels over time in the two treatment arms. The log scale makes everything fit on to the graph, but pay attention to the numbers on the y-axis. #NephJC https://t.co/YIsKMmERZ1 |
| Poyan Mehr @poyanmehr @fervenzafernan1 @rheault_m @NephJC Likely based on the fact that people already were using it more and more off label for this indications? #NephJC |
| Michelle Rheault @rheault_m @fervenzafernan1 @NephJC That's a crying shame. #NephJC Genentech wouldn't even supply the Ritux for our upcoming trial in recurrent FSGS post-transplant (but I hold the IND). |
 | Joshua Waitzman, MD PhD @Jwaitz Hi #NephJC! Sorry I’m late—was busy reading a bedtime story. Nephrology fellow @BIDMChealth. No COI. Glad #MENTOR has gotten us away from the scariest of natural disasters (actual photo of bedtime story) https://t.co/DmQh0lAHxu |
| Vineet Behera @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy #NephJC Thanks for the clarification @fervenzafernan1 |
| Nephrology Journal Club @NephJC T2: What are your thoughts on using anti-PLA2R to track disease activity and as an outcome for PMN trials? #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @NephJC Amazing how aPLA2R rebounds after CSA is tapered off. #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @poyanmehr: @Maximal_Change @christhero10 @hswapnil Did Dr @fervenzafernan1 pick sites, who’s practices are not representative of what most nephrologist and centers seem to use? I haven’t surveyed that but yet have to say that only a minority of nephrologists i know would use CNI as primary tx in severe MN #NephJC |
| fernando fervenza @fervenzafernan1 @poyanmehr @Maximal_Change @christhero10 @hswapnil The majority of academic centers use CSA. This is different than in private practice #nephjc |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 How many of you were using rituximab treatment in your daily clinical practice in MN? What is the % decrease in protein in those who are receiving this therapy? #NephJC |
| Sanjeev Nair @Nair_Sanj @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy Why CsA monotherapy? KDIGO recommends using CsA with steroids and Tac as monotherapy. Given that difference in recommendation, is it still safe to say Tac and CsA are equally efficacious? #NephJC |
| Raymond Hsu @DrRaymondHsu @MitchellLunn @NephJC @NEJM @LaurenceHBeckJ1 Confession: have never prescribed mod-Ponticelli in my *years* . always TAC or RTX so I guess I am prime audience for this study #nephjc |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah #NephTwitter and #NephJC is all the better for it! Thanks for joining. |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 Question to the #nephJC group Has anyone had personal experience taking CNIs on a chronic basis? I hope not but as I have mentioned these are medications with a high risk profile #nephJC |
| Fitsum Asnakech Tilahun MD @fitse_t RT @NephJC: T2: T2: Back to Figure 1 Compared to cyclosporine, Rituximab was noninferior at 12 months and superior at 24 months in achieving the composite remission outcome. #NephJC https://t.co/r4Q09EhgeC |
| Vineet Behera @BeheraVineet @kidneybiz @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy Thanks for the clarification #NephJC |
 | Raja Ramachandran (राजा) @raja_1980 @NephJC 1.Cyclical CYC/GC 2.Rituximab 3.TAC. My sequence for a patient without any contraindication for steroids. Else, swap 1 to 2. #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @gratefull080504 Good point. There was a quality of life metric (KDQOL-SF) that showed no difference between the two groups #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephroGuy: @Maximal_Change @christhero10 @hswapnil @poyanmehr #RICYCLO May give us some light https://t.co/XTuqSf2ufN #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @NephJC: T2: T2: Back to Figure 1 Compared to cyclosporine, Rituximab was noninferior at 12 months and superior at 24 months in achieving the composite remission outcome. #NephJC https://t.co/r4Q09EhgeC |
| Nephrology Journal Club @NephJC RT @Nair_Sanj: @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy Why CsA monotherapy? KDIGO recommends using CsA with steroids and Tac as monotherapy. Given that difference in recommendation, is it still safe to say Tac and CsA are equally efficacious? #NephJC |
| Jon Klein PGY44 🇮🇱 @JonBKlein @SalemAlmaani @edgarvlermamd @NEJM @CristhianMuM @landmark_neph “When I was a fellow...” never mind, we did a lot of dumb stuff back then. #NephJC |
| fernando fervenza @fervenzafernan1 @poyanmehr @Maximal_Change @christhero10 @hswapnil Many sites were invited and many were not interested #nephjc |
| Salem Almaani @SalemAlmaani @cnavadr @LaurenceHBeckJ1 @NephJC we use this combination for severely nephrotic/hypoalbuminemic patients. mainly to the CNIs effects on glomerular pressure and podocyte cytoskeleton #NephJC |
| Nephrology Journal Club @NephJC RT @fervenzafernan1: @poyanmehr @Maximal_Change @christhero10 @hswapnil The majority of academic centers use CSA. This is different than in private practice #nephjc |
| Luis Enrique Alvarez @LuisAlvarezRa I’m stilll giving IV cyclophosphamide #NephJC |
| Joselyn Reyes Bahamonde @jopelina RT @NephJC: T2: T2: Back to Figure 1 Compared to cyclosporine, Rituximab was noninferior at 12 months and superior at 24 months in achieving the composite remission outcome. #NephJC https://t.co/r4Q09EhgeC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Nair_Sanj: @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy Why CsA monotherapy? KDIGO recommends using CsA with steroids and Tac as monotherapy. Given that difference in recommendation, is it still safe to say Tac and CsA are equally efficacious? #NephJC |
| Nephrology Journal Club @NephJC T2: And what about treatment failure? Higher (80%) in cyclosporine group vs rituximab group (40%), as seen in Figure 2. Y-axis plots cumulative incidence of outcome, not disease. #NephJC https://t.co/8Hs7EUMkmZ |
| Poyan Mehr @poyanmehr @Maximal_Change @cnavadr @LaurenceHBeckJ1 @NephJC @kidneydoc101 Likel wise I do use this approach. CNIs have a great temporary antiproteinuric effect which corrects nephrotic syndrome. Yet fail to maintain longterm remission #NephJC |
 | Juan Carlos Q Velez @VelezNephHepato RT @LaurenceHBeckJ1: @NephJC Still waiting for a clinical MN trial to incorporate aPLA2R in the inclusion criteria (eg, stable or rising) or to assess path through clinical trial (eg, treatment failure if <25% drop in aPLA2R)! This could exclude patients already going into spontaneous remission #NephJC |
| Michelle Rheault @rheault_m @poyanmehr @fervenzafernan1 @NephJC Possibly. Labeling makes a huge difference for insurance approval however. Would save time writinng prior auth letters #NephJC |
| Timothy Yau @Maximal_Change @NephJC I’d be shocked if any membranous studies from here on don’t look at it #NephJC |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd GEMRITUX: Rituximab for Severe Membranous Nephropathy ca. 2017 from @JASN_News #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/UrC64vPmuH https://t.co/nr984xPkra |
| R Lafayette @kidneybiz @NephJC May be future state (the supplemental tables strongly support that PLA2R improvements predict remission), but right now still prefer to know proteinuria and GFR. #nephJC |
| fernando fervenza @fervenzafernan1 @poyanmehr @rheault_m @NephJC Yes. But insurance has been a problem because companies say no RCT #nephjc |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn @DrRaymondHsu @NephJC @NEJM @LaurenceHBeckJ1 ** gasp ** #nephjc |
| Alex Meraz @NephroGuy @kidneybiz @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy In Toronto at #UHN most of the patients are caucasic, however people of multiple backgrounds are also seen. They must have data of the effectiveness of cyclosporine in multiple races. #NephJC |
| Nephrology Journal Club @NephJC T2: No statistically significant differences in adverse events, although there were certainly qualitative differences. ⚡️Thoughts or comments on these differences? ⚡️Would they influence your clinical decision-making? #NephJC |
| Verner Venegas @Vernisartan RT @edgarvlermamd: GEMRITUX: GEMRITUX: Rituximab for Severe Membranous Nephropathy ca. 2017 from @JASN_News #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/UrC64vPmuH https://t.co/nr984xPkra |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: T2: T2: And what about treatment failure? Higher (80%) in cyclosporine group vs rituximab group (40%), as seen in Figure 2. Y-axis plots cumulative incidence of outcome, not disease. #NephJC https://t.co/8Hs7EUMkmZ |
| Raja Ramachandran (राजा) @raja_1980 Hi all. Raja Ramachandran from Chandigarh, India. Have no COI to declare. #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @HecmagsMD @HecmagsMD : In my opinion I question the design of the instrument Look at table 3 + there is a difference in headache, dizziness, depression, #nephJC |
| Nephrology Journal Club @NephJC T2: Any thoughts or comments on the quality of life assessment and results? 🌈 #NephJC |
| Timothy Yau @Maximal_Change @NephJC If they don’t measure it....It’s like the old myeloma plasma exchange trials that didn’t measure free light chain reduction. I’m sure @fervenzafernan1 will recall those. #NephJC |
| Nephrology Journal Club @NephJC RT @JonBKlein: @SalemAlmaani @edgarvlermamd @NEJM @CristhianMuM @landmark_neph “When I was a fellow...” never mind, we did a lot of dumb stuff back then. #NephJC |
| Tiffany Caza @Tiff_Caza @NephJC @Neph_Sim @ChangUCanSpare @arkanalabs Changes on silver stains are seen in stage II - IV electron dense deposits, with stage II deposits showing spikes and stage III showing holes. In early membranous you may not see any changes on light microscopy but you have deposits seen by IF & EM. #nephjc |
| Nephrology Journal Club @NephJC RT @fervenzafernan1: @poyanmehr @Maximal_Change @christhero10 @hswapnil Many sites were invited and many were not interested #nephjc |
| Juan Carlos Q Velez @VelezNephHepato @NephJC That’s a must do in my practice now #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @gratefull080504 I have not. But I empathize with my patients… lots of AEs. #NephJC |
| R Lafayette @kidneybiz @LaurenceHBeckJ1 @NephJC T cell influences of B cell function must be more recoverable compared to cytotoxics or RTX effects on B cells directly.? #nephJC |
| Rolando Claure, MD, FASN, FISN 🇧🇴 @RClaure_nefro @HecmagsMD @signindoc Not first choice #NephJC , I would have compared against cyclophosphamide https://t.co/IECAmzoh5T |
| Nephrology Journal Club @NephJC RT @edgarvlermamd: GEMRITUX: GEMRITUX: Rituximab for Severe Membranous Nephropathy ca. 2017 from @JASN_News #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/UrC64vPmuH https://t.co/nr984xPkra |
 | Muniba Javed @Mnbajvd RT @kidney_boy: Nice #VisualAbstract, just in time for tonight's #NephJC chat! |
| Nephrology Journal Club @NephJC RT @fervenzafernan1: @poyanmehr @rheault_m @NephJC Yes. But insurance has been a problem because companies say no RCT #nephjc |
| Mohamed E. Elrggal @M_Elraggal RT @PabloGarciaMD: @ssfarouk @hswapnil @NephJC @kidneybiz @fervenzafernan1 #Nephjc this is the explanation at the NEJM appendix https://t.co/wa5NOMMyMj |
| Alex Meraz @NephroGuy @cnavadr @LaurenceHBeckJ1 @NephJC #STARMEN it’s coming!!! #NephJC https://t.co/PBK6fcbww6 |
| fernando fervenza @fervenzafernan1 @rheault_m @NephJC Shame is the NIDDK refusing to give 25% of funding, when Genentech and a private foundation confirmed 75% of funding #nephjc |
| Nephrology Journal Club @NephJC T3: Now let’s move on to Discussion. #NephJC https://t.co/OUWEmMLqOx |
| Joshua Waitzman, MD PhD @Jwaitz @gratefull080504 Hi @gratefull080504! Although I haven’t taken either med, I will say that many people find the short course of infusions much easier to manage from a logistics standpoint than daily or twice a day meds. #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @HecmagsMD Hector I know you do + that is why #PROM are so important #nephJC |
| Timothy Yau @Maximal_Change @poyanmehr @cnavadr @LaurenceHBeckJ1 @NephJC @kidneydoc101 Same. I’ve seen plenty of Rituxan remissions relapse without any maintenance. At least mentor redosed them #NephJC |
| Ross Morton @signindoc RT @RClaure_nefro: @HecmagsMD @signindoc Not first choice #NephJC , I would have compared against cyclophosphamide https://t.co/IECAmzoh5T |
| Alex Meraz @NephroGuy RT @edgarvlermamd: GEMRITUX: GEMRITUX: Rituximab for Severe Membranous Nephropathy ca. 2017 from @JASN_News #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/UrC64vPmuH https://t.co/nr984xPkra |
| Nephrology Journal Club @NephJC T3: We asked you before the chat what your pre-MENTOR PMN treatment approach was. Will the MENTOR study change the therapeutic options you offer your patients? Comment below! #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz I was wondering about this reasons #NephJC why not Cyc = modified Ponticelli regimen |
| Nephrology Journal Club @NephJC T3: Check back tomorrow for poll results. #NephJC |
| Nephrology Journal Club @NephJC RT @NephJC: T3: T3: We asked you before the chat what your pre-MENTOR PMN treatment approach was. Will the MENTOR study change the therapeutic options you offer your patients? Comment below! #NephJC |
| R Lafayette @kidneybiz @Nair_Sanj @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy There are numerous, but small, cyclo monotherapy studies that look as effective as cyclo-steroid combo or tacro monotherapy. #nephjc |
| Raymond Hsu @DrRaymondHsu @NephJC It's surprising about a quarter of patients were serum anti-PLA2R negative to start with. Already on way to remission vs different disease? #NephJC |
| Alex Meraz @NephroGuy @fervenzafernan1 @poyanmehr @rheault_m @NephJC Maybe after #MENTOR this issue will improve #NephJc |
| Timothy Yau @Maximal_Change @aishaikh @NephJC @fervenzafernan1 There was an editorial I still remember where they said “Not measuring free light chains in these patients is akin to not measuring blood pressure in an anti hypertensive trial” #savage #NephJC |
| fernando fervenza @fervenzafernan1 @Nair_Sanj @BeheraVineet @LaurenceHBeckJ1 @hswapnil @kidney_boy It’s is a myth that you need steroids with CSA. It comes from the old believe that would protect against nephro toxicity #nephjc |
| Nephrology Journal Club @NephJC T3: What are some strengths and limitations of the study? #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Jwaitz @Jwaitz: Im my opinion this is why we need better #PROM that focus on improving quality of life I can't tell how much routine exercise has mediated the QOL issues As always Thank you for listening! #nephJC |
| R Lafayette @kidneybiz @HecmagsMD @gratefull080504 Stay tuned, there will be more about the PRO/QOL and this study in the future. #NephJC |
| Michelle Rheault @rheault_m @fervenzafernan1 @NephJC Surely the big Kidney announcement tomorrow will include ample funding for nephrology RCTs #NephJC (That's sarcasm in case it didn't come through) |
| Bhavnish @Buck1486 @poyanmehr @Maximal_Change @cnavadr @LaurenceHBeckJ1 @NephJC @kidneydoc101 I think that would be mainly due to the effect of CNI on the intra glomerular pressures leading to improved proteinuria rather than addressing the underlying cause of primary membranous. #NephJc |
| Nephrology Journal Club @NephJC RT @Jwaitz: Hi #NephJC! Sorry I’m late—was busy reading a bedtime story. Nephrology fellow @BIDMChealth. No COI. Glad #MENTOR has gotten us away from the scariest of natural disasters (actual photo of bedtime story) https://t.co/DmQh0lAHxu |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil #NephJC |
| fernando fervenza @fervenzafernan1 @Nair_Sanj @BeheraVineet @LaurenceHBeckJ1 @hswapnil @kidney_boy Yes. TAC and CSA are equally good. But neoral is more reliable for pharmacokinetics #nephjc |
| Krithika Mohan @krithicism RT @fervenzafernan1: @Nair_Sanj @BeheraVineet @LaurenceHBeckJ1 @hswapnil @kidney_boy It’s is a myth that you need steroids with CSA. It comes from the old believe that would protect against nephro toxicity #nephjc |
| Nephrology Journal Club @NephJC What say you, #NephTwitter? #NephJC |
| Eric Au @ericau @Maximal_Change @aishaikh @NephJC @fervenzafernan1 Sounds pretty terrible when you put it that way #nephjc |
 | devika nair md msci @devimol @NephJC appreciate that both ITT and per-protocol analyses were published in the Supplement so we can see if both approaches supported non-inferiority #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @fervenzafernan1: @Nair_Sanj @BeheraVineet @LaurenceHBeckJ1 @hswapnil @kidney_boy It’s is a myth that you need steroids with CSA. It comes from the old believe that would protect against nephro toxicity #nephjc |
| Alex Meraz @NephroGuy @RClaure_nefro @HecmagsMD @signindoc Only two center agreed to use CFM. Almost nobody uses CFM anymore, at least in US and Canada. #NephJC |
| Juan Carlos Q Velez @VelezNephHepato CYC/MP Ponticelli had 93% remission rate at 1 yr, RTX 60% and tacro 54% here in MENTOR. Very clear to me. #timetoremissionmatters #NephJC |
| Poyan Mehr @poyanmehr @VelezNephHepato @NephJC If pla2r trending down than I may even not treat. Important in guiding decision. Even though more studies needed to affirm #NephJC |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn @DrRaymondHsu @NephJC Or are there multiple antiPLA2R antibodies created and our current assay only detects antibodies for certain epitomes? Anyone know the details of the assay? #nephjc |
| Nephrology Journal Club @NephJC RT @poyanmehr: @VelezNephHepato @NephJC If pla2r trending down than I may even not treat. Important in guiding decision. Even though more studies needed to affirm #NephJC |
| Nephrology Journal Club @NephJC RT @devimol: @NephJC appreciate that both ITT and per-protocol analyses were published in the Supplement so we can see if both approaches supported non-inferiority #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @poyanmehr @VelezNephHepato @NephJC Yes - that is why a run-in measuring aPLA2R is so important! #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @rheault_m @fervenzafernan1 @NephJC The new kidney plan will fix everything. #nephJC https://t.co/gSfEoWaCPu |
| Timothy Yau @Maximal_Change @NephJC It’s a first line option now. Although I’m still worried about relapses and would love to see long term data. And still would make me nervous if proteinuria 10+ grams with severe nephrotic syndrome. But that’s saying a lot compared to where I was two weeks ago #NephJC |
| Nephrology Journal Club @NephJC @MitchellLunn @DrRaymondHsu CC: @LaurenceHBeckJ1 #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC I think this a very good + important study My only suggestion to my #nephJC friends is to consider the state of QOL instruments + consider making this a priority Improving quality of life across the spectrum of #ckd is an unmet patient need #nephJC |
| fernando fervenza @fervenzafernan1 @Maximal_Change @NephJC Yes! #nephjc |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @MitchellLunn @DrRaymondHsu @NephJC Measures antibodies against all epitopes in the extracellular domain (ie., all of them) #NephJC |
| Ross Morton @signindoc #NephJC Given that two other MGN studies with tacrolimus and with cyclophosphamide and rituximab have been mentioned, are investigaotrs competing against one another to recruit? |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: Discovery of PLA2R and THSD7A has led to a paradigm shift in diagnosis, monitoring, and classification of patients #Nephpearls #NephJC 👉🏼 https://t.co/lgbcRGuKyz https://t.co/ZT64V9gzZw |
| Sanjeev Nair @Nair_Sanj @NephJC @Stones__ Ok need to get ready for work. Good chat Jennie. Here's how i'm hoping this discussion ends. #NephJC #CycloIsStillSexy;) https://t.co/ovtwYO9FLA |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn @DrRaymondHsu @NephJC Epitopes *** #nephjc |
| Nephrology Journal Club @NephJC T3: Rituximab is not a perfect therapy by any means. For the scientists and innovators in the group, how would you design an even more efficacious, effective, and tolerated therapeutic to treat PMN? #NephJC https://t.co/8TM8lk5wjY |
| Pablo Garcia @PabloGarciaMD RT @kidneybiz: @HecmagsMD @gratefull080504 Stay tuned, there will be more about the PRO/QOL and this study in the future. #NephJC |
| Juan Carlos Q Velez @VelezNephHepato @poyanmehr @NephJC Sam where. If low titer at baseline, no IS. if titer intermediate but tending down, no IS. IF titer high at baseline, IS from time zero #NephJC |
| Nephrology Journal Club @NephJC T3: @LaurenceHBeckJ1 are you at liberty to share any glimmers of hope for additional PMN therapeutics coming down the pipeline? #NephJC |
| Hector Madariaga, MD FASN 🇲🇽 @HecmagsMD @gratefull080504 I see that. However, statistically speaking (CC @hswapnil ), AEs were similar in both groups. Authors also mention that 7 patients (11%) discontinued cyclosporine because of severe AEs. #NephJC |
| Bhavnish @Buck1486 RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Discovery of PLA2R and THSD7A has led to a paradigm shift in diagnosis, monitoring, and classification of patients #Nephpearls #NephJC 👉🏼 https://t.co/lgbcRGuKyz https://t.co/ZT64V9gzZw |
| Timothy Yau @Maximal_Change @DrRaymondHsu @NephJC That’s about standard with other cohorts looking at primary membranous. About 30% pts are PLa2R ab negative. It’s not the only antibody #NephJC |
| Sanjeev Nair @Nair_Sanj RT @kidneybiz: @Nair_Sanj @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy There are numerous, but small, cyclo monotherapy studies that look as effective as cyclo-steroid combo or tacro monotherapy. #nephjc |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @NephJC CAR-T against anti-PLA2R producing B cells or tolerance #NephJC |
| fernando fervenza @fervenzafernan1 @aishaikh @Maximal_Change @NephJC In MENTOR, all patients had to have biopsy results by LM, IF and EM #nephjc |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn RT @LaurenceHBeckJ1: @MitchellLunn @DrRaymondHsu @NephJC Measures antibodies against all epitopes in the extracellular domain (ie., all of them) #NephJC |
| Mitchell R. Lunn MD MAS 🏳️🌈 (he/him) @MitchellLunn @LaurenceHBeckJ1 @DrRaymondHsu @NephJC Awesome! Thanks! #NephJc |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil MENTOR effect on #NephJC website cc @fervenzafernan1 & @kidneybiz https://t.co/iZy3wb38Bb |
 | Graham Abra, MD @GrahamAbra @kidneybiz @HecmagsMD @gratefull080504 Interested to see these, in my hands Ritux has been much preferred to CsA by pts #NephJC |
| Joshua Waitzman, MD PhD @Jwaitz @GlassockJ @NephroGuy @poyanmehr @hswapnil @fervenzafernan1 Do other folks see parallels with #SONAR, in which our best “biomarker” (here PLA2R, there proteinuria) doesn’t necessarily correlate with treatment response? Gotta keep looking for those biomarkers #nephjc |
| Tiffany Caza @Tiff_Caza RT @edgarvlermamd: GEMRITUX: GEMRITUX: Rituximab for Severe Membranous Nephropathy ca. 2017 from @JASN_News #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/UrC64vPmuH https://t.co/nr984xPkra |
| Nephrology Journal Club @NephJC Oooo ... now THAT is fascinating! #NephJC |
| Nephrology Journal Club @NephJC RT @hswapnil: MENTOR effect on #NephJC website cc @fervenzafernan1 & @kidneybiz https://t.co/iZy3wb38Bb |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC This trial is important because it provides hope that renal function can be preserved better That is significant #nephJC |
| Michelle Rheault @rheault_m @fervenzafernan1 @aishaikh @Maximal_Change @NephJC Central path review was a strength for MENTOR study, I think. #NephJC |
| Alex Meraz @NephroGuy @VelezNephHepato Why doesn’t it matter? Better hard outcomes in the long run? What about giving calcineurin inhibitors + Rituximab and then taper them down #STARMEN https://t.co/PBK6fcbww6 #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @Jwaitz: @GlassockJ @NephroGuy @poyanmehr @hswapnil @fervenzafernan1 Do other folks see parallels with #SONAR, in which our best “biomarker” (here PLA2R, there proteinuria) doesn’t necessarily correlate with treatment response? Gotta keep looking for those biomarkers #nephjc |
| Rolando Claure, MD, FASN, FISN 🇧🇴 @RClaure_nefro @NephroGuy @HecmagsMD @signindoc That means that “almost” the rest of the world 🌎 still use cyclophosphamide 🤔 #NephJC |
| Juan Carlos Q Velez @VelezNephHepato @LaurenceHBeckJ1 @MitchellLunn @DrRaymondHsu @NephJC #NephJC @LaurenceHBeckJ1 is the French group developing a clinical assay for epitope spreading? |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @GrahamAbra @kidneybiz @HecmagsMD Graham, I am not surprised #nephJC |
| Nephrology Journal Club @NephJC T3: We will be winding down in a few minutes. What are your take home points? Final thoughts or comments? #NephJC |
| Graham Abra, MD @GrahamAbra Graham Abra here, joining late now kids in bed, former @kidneybiz fellow, equal opportunity dialyzer and employee @satellitehealth #NephJC |
 | Matthew Sparks, MD @Nephro_Sparks I’m here to drop a hashtag #NephJC and boost the impressions 😜 #ProRitux #ProPLA2R #AntiCNI #MentorOut https://t.co/9vjxArIwdm |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah GN is firmly in Transplant territory! #NephJC Exciting! |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @VelezNephHepato @MitchellLunn @DrRaymondHsu @NephJC Gerard Lambeau has pioneered this. Not sure if clinical assay coming or not. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil @NephroGuy @RClaure_nefro @HecmagsMD @signindoc Outside Toronto they do, in Canada 😏 #NephJC |
| fernando fervenza @fervenzafernan1 @rheault_m @NephJC Yes! We had 2 preliminary studies published in KI and CJASn showing phamaxokinetics and pharmacodynamics and strong clinical response #nephjc |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 @NephJC Do you think that the short follow-up was enough to see any difference between both therapy?#NephJC |
| Ross Morton @signindoc RT @hswapnil: @NephroGuy @RClaure_nefro @HecmagsMD @signindoc Outside Toronto they do, in Canada 😏 #NephJC |
| Alex Meraz @NephroGuy @LaurenceHBeckJ1 @NephJC Is there any trial using proteasome inhibitors or daratumumab? #NephJC |
| Juan Carlos Q Velez @VelezNephHepato @NephroGuy What I am trying to say is that it does matter how quickly you achieve remission. RTX takes forever. Yes the STARMEN protocol may offer a nice new alternative. Already doing something like it in cases where I can’t use CYC #NephJC |
| Nephrology Journal Club @NephJC Drive-by tweeting by @Nephro_Sparks! #NephJC |
| Timothy Yau @Maximal_Change Fantastic chat. Thanks to the authors @LaurenceHBeckJ1 and @fervenzafernan1 for coming out and sharing their insight. Exciting times in nephrology! #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @Maximal_Change @fervenzafernan1 Again ... not an author. Just very interested party! #NephJC |
| fernando fervenza @fervenzafernan1 @rheault_m @NephJC Then we had with Larry Beck the biomarker paper in JASN showing relationship between antibodies and proteinuria #nephjc |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah RT @hswapnil: @NephroGuy @RClaure_nefro @HecmagsMD @signindoc Outside Toronto they do, in Canada 😏 #NephJC |
| Sanjeev Nair @Nair_Sanj @NephJC Here's why i feel that while #MENTOR solidified Rituximab's position in the PMN armementarium, it won't change practice for many. Despite what we've heard today many ppl still use Ponticelli. Many believe Tac > CsA https://t.co/QpM7OZ5zW7 #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephJC To me the renal preservation is the key takeaway, + would be interested in longer term studies Looks like QOL will be studies via #PROM Overall important study + I thank the investigators + patients who participated in the trial Significant progress #nephJC |
| Juan Carlos Q Velez @VelezNephHepato @NephroGuy @LaurenceHBeckJ1 @NephJC I have an n=1 with bortezomib: failed #NephJC |
| R Lafayette @kidneybiz @MarvinGonzlez16 @NephJC I think the difference in relapses and in sustained control of PLA2R Abs are pretty substantial in the short term. Main limitation is not seeing what longer term CNI could do, but likely would have associated AEs, cost and toxicity. #nephjc |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @fervenzafernan1 @rheault_m @NephJC With Dr. Fervenza co-first author ... #NephJC |
| Alex Meraz @NephroGuy @cnavadr @Buck1486 @poyanmehr @Maximal_Change @LaurenceHBeckJ1 @NephJC @kidneydoc101 Not proven 100%. calcineurin Inhibitores are definitely immunosuppressive albeit inespecific #NephJC |
| Michelle Rheault @rheault_m @NephJC That was a barn burner #NephJC. You officially broke me. I couldn't keep up with you all. Every GN patient should be enrolled in a trial. See here for possibilities: https://t.co/ZCTDPfZciQ |
| Poyan Mehr @poyanmehr @LaurenceHBeckJ1 @Maximal_Change @Furqi @christhero10 @hswapnil Though I would add “perceived”. We don’t know if we to do the trial. Well designed RCTs pitching RTX and CTX again each other have not uniformly shown this fear to be justified #NephJC. Many, many centers and practices use CTX where there is a role for CTX |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @NephJC: T1: T1: Intervention Rituximab arm: 1000 mg IV on days 1 and 15 (donated by Genentech) Cyclosporine arm: 3.5 mg per kg per day every 12 hours with dose adjustment to target trough and for bump in serum creatinine #NephJC |
| Nephrology Journal Club @NephJC If you haven’t already, please sign up for our weekly newsletter https://t.co/5aumn8ImwF #NephJC https://t.co/Y62bX2ZwP9 |
| Nephrology Journal Club @NephJC Would you like to have some #NephJC swag? Order it here https://t.co/eTUrZYjJeY https://t.co/KRwb5vbbty |
| fernando fervenza @fervenzafernan1 @rheault_m @NephJC Then we had 75% of the money. And still NIDDK refused us to submit the reply to the initial review that said proposal was outstanding #nephjc |
| Joshua Waitzman, MD PhD @Jwaitz I’m sold on rituximab for MN! I think we may have to start getting used to positive trials in Nephrology...so long as they don’t go to our heads #nephJC https://t.co/kJxv0fhdJj |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @rheault_m @NephJC Amen to that #nephJC |
| Alex Meraz @NephroGuy @LaurenceHBeckJ1 @NephJC ACTH? I don’t think it have a role in MN. Do you have any data? #NephJC |
| Mohamed E. Elrggal @M_Elraggal @VelezNephHepato can u provide reference for the "93%" number? #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @NephroGuy @cnavadr @Buck1486 @poyanmehr @Maximal_Change @LaurenceHBeckJ1 @NephJC @kidneydoc101 With significant side effect burdens #nephJC |
| Samira Farouk, MD, MSCR @ssfarouk @NephroGuy @LaurenceHBeckJ1 @NephJC Small ACTH RCT #NephJC https://t.co/08eSYQu4Td |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @NephroGuy @NephJC I have only used ACTH as salvage therapy. But may be effective ... #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @kidneybiz @MarvinGonzlez16 @NephJC Your response matches mine #nephJC |
| Juan Carlos Q Velez @VelezNephHepato I would have liked seeing an editorial from Jack Wetzels instead #NephJC |
 | Clarissa Araujo Cassol @ClarissaCassol Clarissa Cassol, renal pathologist, no COI, just lurking #nephjc |
 | Roberto Gutiérrez @DrRobertoGuti RT @edgarvlermamd: Controlled Trial of Methylprednisolone and Chlorambucil in Idiopathic Membranous Nephropathy ca. 1984 from @NEJM #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/KcY2ZcuLJK https://t.co/wSoSeqRAJx |
| Roberto Gutiérrez @DrRobertoGuti RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Treatment regimens PRE-MENTOR #Nephpearls #NephJC https://t.co/deVFJis603 |
| fernando fervenza @fervenzafernan1 @rheault_m @aishaikh @Maximal_Change @NephJC Yes! It was review by 4 people #nephjc |
| Samira Farouk, MD, MSCR @ssfarouk @NephroGuy @LaurenceHBeckJ1 @NephJC Broken link ACTH RCT for PMN #NephJC https://t.co/bSuEfCvqbl #NephJC |
 | Cristhian Muñoz 🇲🇽 @CristhianMuM RT @edgarvlermamd: GEMRITUX: GEMRITUX: Rituximab for Severe Membranous Nephropathy ca. 2017 from @JASN_News #VisualAbstract by @CristhianMuM #Nephpearls #NephJC 👉🏼 https://t.co/UrC64vPmuH https://t.co/nr984xPkra |
| Poyan Mehr @poyanmehr @fervenzafernan1 @Maximal_Change @christhero10 @hswapnil Shame in those who weren’t interested. Too bad I was a resident when this all started #NephJC |
| Roberto Gutiérrez @DrRobertoGuti RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: Proposed categorization ca. 2019 from @goKDIGO @Kidney_Int #Nephpearls #NephJC 👉🏼 https://t.co/LuNew12UwI https://t.co/iHWyJDbIu5 |
| Roberto Gutiérrez @DrRobertoGuti RT @edgarvlermamd: MENTOR: MENTOR: Rituximab (vs Cyclosporine) for Membranous GN ca. 2019 from @NEJM 📌 Non-inferior in inducing complete/ partial remission of proteinuria at 12 months #Nephpearls #NephJC 👉🏼 https://t.co/0iLPPejnqM https://t.co/AufZ5Gn7Jv |
| Roberto Gutiérrez @DrRobertoGuti RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: This schematic presents a categorization of primary MN into subgroups on the basis of association with the two known antigens, PLA2R and THSD7A ca. 2017 from @JASN_News #Nephpearls #NephJC 👉🏼 https://t.co/I9Meoi8ikK https://t.co/WGoWkpdjap |
| Tiffany Caza @Tiff_Caza @NephJC SGLT2 inhibitors along with rituximab? There's SGLT2 expression in podocytes in biopsies with membranous but not control kidney biopsies, and SGLT2 inhibitors reduce proteinuria. Crazy idea? #nephjc https://t.co/iV1pnjHft0 |
| Edgar V. Lerma 🇵🇭 @edgarvlermamd Membranous Nephropathy: 2 important RCTs published since tjr 2012 @goKDIGO Guidelines on Glomerulonephritis were published #Nephpearls #NephJC #VisualAbstract by @CristhianMuM ✅ GEMRITUX https://t.co/UrC64vPmuH ✅ MENTOR https://t.co/GhfVMCPr4k https://t.co/fQrXoylRNp |
| Graham Abra, MD @GrahamAbra @ssfarouk @NephroGuy @LaurenceHBeckJ1 @NephJC Color me skeptical of Acthar #NephJC |
| Angel Cesar Ortiz @AngelCesarOrtiz RT @hswapnil: MENTOR effect on #NephJC website cc @fervenzafernan1 & @kidneybiz https://t.co/iZy3wb38Bb |
| Nephrology Journal Club @NephJC RT @Tiff_Caza: @NephJC SGLT2 inhibitors along with rituximab? There's SGLT2 expression in podocytes in biopsies with membranous but not control kidney biopsies, and SGLT2 inhibitors reduce proteinuria. Crazy idea? #nephjc https://t.co/iV1pnjHft0 |
| Samira Farouk, MD, MSCR @ssfarouk RT @Tiff_Caza: @NephJC SGLT2 inhibitors along with rituximab? There's SGLT2 expression in podocytes in biopsies with membranous but not control kidney biopsies, and SGLT2 inhibitors reduce proteinuria. Crazy idea? #nephjc https://t.co/iV1pnjHft0 |
| Nephrology Journal Club @NephJC RT @ssfarouk: @NephroGuy @LaurenceHBeckJ1 @NephJC Broken link ACTH RCT for PMN #NephJC https://t.co/bSuEfCvqbl #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @VelezNephHepato @NephroGuy The half life of RTX is 22 days correct vs 8 hours with cycle, correct ? #nephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @Tiff_Caza @NephJC CREDENCE 2?? #NephJC |
| Bhavnish @Buck1486 @NephroGuy @cnavadr @poyanmehr @Maximal_Change @LaurenceHBeckJ1 @NephJC @kidneydoc101 Agree CSA definitely has some immunosuppressive attributes but at least with this study we can say we are hitting closer to targeted therapy than with CSA only. #nephJC |
| Nephrology Journal Club @NephJC RT @LaurenceHBeckJ1: @Tiff_Caza @NephJC CREDENCE 2?? #NephJC |
| Itunu @itunuowoyemi @NephJC What about the 40% non-responders to Ritux ? Any thoughts to why this happened? Any similarities with CSA non responders #NephJC |
| Verner Venegas @Vernisartan RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: 2 important RCTs published since tjr 2012 @goKDIGO Guidelines on Glomerulonephritis were published #Nephpearls #NephJC #VisualAbstract by @CristhianMuM ✅ GEMRITUX https://t.co/UrC64vPmuH ✅ MENTOR https://t.co/GhfVMCPr4k https://t.co/fQrXoylRNp |
| Nephrology Journal Club @NephJC RT @itunuowoyemi: @NephJC What about the 40% non-responders to Ritux ? Any thoughts to why this happened? Any similarities with CSA non responders #NephJC |
| Cristhian Muñoz 🇲🇽 @CristhianMuM RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: 2 important RCTs published since tjr 2012 @goKDIGO Guidelines on Glomerulonephritis were published #Nephpearls #NephJC #VisualAbstract by @CristhianMuM ✅ GEMRITUX https://t.co/UrC64vPmuH ✅ MENTOR https://t.co/GhfVMCPr4k https://t.co/fQrXoylRNp |
| Verner Venegas @Vernisartan RT @Tiff_Caza: @NephJC SGLT2 inhibitors along with rituximab? There's SGLT2 expression in podocytes in biopsies with membranous but not control kidney biopsies, and SGLT2 inhibitors reduce proteinuria. Crazy idea? #nephjc https://t.co/iV1pnjHft0 |
| Ross Morton @signindoc #NephJC Happy with rituximab (#MENTOR) as an antibody depleting (+) therapy for an antibody mediated (+) disease. Need to know the why. Why make an antibody against PLA2R? There is the real target problem. |
| R Lafayette @kidneybiz @VelezNephHepato Watch for the results of Ri_ciclo study at some point. #nephjc |
| Alex Meraz @NephroGuy @RClaure_nefro @HecmagsMD @signindoc I dont know about Europe, certainty in Italy they have been usin Rituximab for ages, or Japan. The rest of the developing world for sure. #NephJC |
| fernando fervenza @fervenzafernan1 @LaurenceHBeckJ1 @Maximal_Change Larry has been great! Without him there would be no PLA2R! #nephjc |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @Buck1486 @NephroGuy @cnavadr @poyanmehr @Maximal_Change @LaurenceHBeckJ1 @NephJC @kidneydoc101 without a doubt! #nephJC |
| Marvin Gonzalez. MD, Ph.D @MarvinGonzlez16 RT @itunuowoyemi: @NephJC What about the 40% non-responders to Ritux ? Any thoughts to why this happened? Any similarities with CSA non responders #NephJC |
| Nephrology Journal Club @NephJC RT @fervenzafernan1: @LaurenceHBeckJ1 @Maximal_Change Larry has been great! Without him there would be no PLA2R! #nephjc |
| Jon Klein PGY44 🇮🇱 @JonBKlein Great discussion. I learned a lot. Where’s the #NephJC after party? Goodnight all! |
| Fitsum Asnakech Tilahun MD @fitse_t @Tiff_Caza @NephJC Love this . #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 @GrahamAbra @ssfarouk @NephroGuy @LaurenceHBeckJ1 @NephJC Me too #nephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @fervenzafernan1 @Maximal_Change Group effort on the PLA2R ... lots of history. And of course no RTX trials without Fernando! #NephJC |
| Poyan Mehr @poyanmehr What have you been using for primary induction of severe primary MN? If you pick CTX, reach@out to @fervenzafernan1 so he can pick you as a site for his next trial #NephJC |
| fernando fervenza @fervenzafernan1 RT @edgarvlermamd: Membranous Nephropathy: Membranous Nephropathy: 2 important RCTs published since tjr 2012 @goKDIGO Guidelines on Glomerulonephritis were published #Nephpearls #NephJC #VisualAbstract by @CristhianMuM ✅ GEMRITUX https://t.co/UrC64vPmuH ✅ MENTOR https://t.co/GhfVMCPr4k https://t.co/fQrXoylRNp |
| Michelle Rheault @rheault_m @fervenzafernan1 @LaurenceHBeckJ1 @Maximal_Change Nephrology research is a team sport. Anyone who thinks they can do it on their own is wrong. Keep up the collaborations. #NephJC |
| Nephrology Journal Club @NephJC Keeping the bar open an extra 5 minutes to let people finish. But please do feel free to keep the #NephJC hashtag going and keep talking! |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @fervenzafernan1 @Maximal_Change ... and the Bergamo group who started it all! #NephJC |
| Mohamed E. Elrggal @M_Elraggal Good question #Nephjc |
| fernando fervenza @fervenzafernan1 RT @LaurenceHBeckJ1: @fervenzafernan1 @Maximal_Change Group effort on the PLA2R ... lots of history. And of course no RTX trials without Fernando! #NephJC |
| Alex Meraz @NephroGuy @Jwaitz @GlassockJ @poyanmehr @hswapnil @fervenzafernan1 Same for FLC removal with high cut-off filters in Myeloma Kidney. Lower FLC were not associated with better hard outcomes #NephJC |
| Kevin J. Fowler Principal The Voice of the Patient @gratefull080504 #NephJC Great topic + learned a lot See you @kidney_boy in DC tomorrow Look for live tweets from me on the HHS announcement tomorrow #nephJC |
| Matthew Sparks, MD @Nephro_Sparks RT @ssfarouk: T0: T0: @Neph_Sim Case 35 #NephJC https://t.co/mBB2KygL1P https://t.co/bgywnwSfGv |
| Ross Morton @signindoc RT @rheault_m: @fervenzafernan1 @LaurenceHBeckJ1 @Maximal_Change Nephrology research is a team sport. Anyone who thinks they can do it on their own is wrong. Keep up the collaborations. #NephJC |
| Nephrology Journal Club @NephJC Thank you all for joining the conversation about the MENTOR study and making this #NephJC chat great! Special shout out to the authors, GN experts, and trainees! Don’t forget we have two additional chats coming up July 10, 9 pm India ST and 9 pm British ST. Good night! |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @M_Elraggal Jon Hogan at Penn had a great case that he will hopefully write up, and Beppe Remuzzi is very interested in use of anti-CD38 in MN. #NephJC |
| Juan Monkey @juandiaznz Kheee https://t.co/aJdot5TYd0 |
| Poyan Mehr @poyanmehr RT @poyanmehr: What have you been using for primary induction of severe primary MN? If you pick CTX, reach@out to @fervenzafernan1 so he can pick you as a site for his next trial #NephJC |
| Alex Meraz @NephroGuy @GrahamAbra @ssfarouk @LaurenceHBeckJ1 @NephJC Likewise #NephJC |
| R Lafayette @kidneybiz @NephJC Thanks for discussing the paper, happy to keep responding (with Fernando's help). Lets keep doing kidney trials!!! #nephJC Good night! |
| Nephrology Journal Club @NephJC RT @LaurenceHBeckJ1: @M_Elraggal Jon Hogan at Penn had a great case that he will hopefully write up, and Beppe Remuzzi is very interested in use of anti-CD38 in MN. #NephJC |
| Timothy Yau @Maximal_Change @LaurenceHBeckJ1 @fervenzafernan1 In the membranous story so many to thank throughout history. Jones, Heymann, Couser, Beck, Salant, it’s a who’s who of nephrology giants. #NephJC |
| fernando fervenza @fervenzafernan1 @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| Nephrology Journal Club @NephJC RT @kidneybiz: @NephJC Thanks for discussing the paper, happy to keep responding (with Fernando's help). Lets keep doing kidney trials!!! #nephJC Good night! |
| Nephrology Journal Club @NephJC RT @Maximal_Change: @LaurenceHBeckJ1 @fervenzafernan1 In the membranous story so many to thank throughout history. Jones, Heymann, Couser, Beck, Salant, it’s a who’s who of nephrology giants. #NephJC |
| Fitsum Asnakech Tilahun MD @fitse_t @NephJC Thank you . A lot of learning and updates as usual from leaders in the field. Love it when the authors join and explain , and also share their experiences #NephJC 👏👏 |
| Joshua Waitzman, MD PhD @Jwaitz @NephJC Great chat @jenniejlin and thanks to @fervenzafernan1 and @LaurenceHBeckJ1 for their expert insight! #nephjc |
| Nephrology Journal Club @NephJC RT @poyanmehr: What have you been using for primary induction of severe primary MN? If you pick CTX, reach@out to @fervenzafernan1 so he can pick you as a site for his next trial #NephJC |
| Harish Seethapathy @BetterCallSeeth #NephJC My personal take home: Very Bad MN: Ritux + low dose cyclo (home regimen, so I am sticking to it) https://t.co/ih91qIHVZP Bad MN: Ritux Not so Bad: No Immunosuppression. Not trained in CsA/Tac for MN, don't envision using it. PLA2R levels: Gold! |
| fernando fervenza @fervenzafernan1 @LaurenceHBeckJ1 @Maximal_Change Yes! But Larry and David revolutionized MN. You can use PLA2R for diagnosis, prognosis and to follow treatment #Nephjc |
| Juan Carlos Q Velez @VelezNephHepato @kidneydoc101 @NephroMD @LaurenceHBeckJ1 Let’s tone down the exaggerated cancer propaganda. A 70 kg pt gets 100mg daily (~1.5 mg/kg). With PLA2R tracking serological remission, u cut treatment to ~ 4 mo; that’s 12g CYC, 1/3 of amount estimated. Issue still to address is recurrence. Wetzels group in it #NephJC |
| Nephrology Journal Club @NephJC RT @rheault_m: @NephJC That was a barn burner #NephJC. You officially broke me. I couldn't keep up with you all. Every GN patient should be enrolled in a trial. See here for possibilities: https://t.co/ZCTDPfZciQ |
| Graham Abra, MD @GrahamAbra RT @poyanmehr: What have you been using for primary induction of severe primary MN? If you pick CTX, reach@out to @fervenzafernan1 so he can pick you as a site for his next trial #NephJC |
| fernando fervenza @fervenzafernan1 @JonBKlein @rheault_m @LaurenceHBeckJ1 @Maximal_Change Yes! #NephJC |
 | Wisit Cheungpasitporn MD FACP | FASN | FAST @wisit661 RT @poyanmehr: What have you been using for primary induction of severe primary MN? If you pick CTX, reach@out to @fervenzafernan1 so he can pick you as a site for his next trial #NephJC |
| Vipin Varghese @vipvargh Saw my first ever MN case two weeks ago...just in time for today's #NephJC. Great chat, thanks all! https://t.co/sooUVSDqdN |
| Wisit Cheungpasitporn MD FACP | FASN | FAST @wisit661 RT @fervenzafernan1: @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah RT @fervenzafernan1: @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| Nephrology Journal Club @NephJC RT @Tiff_Caza: @NephJC @Neph_Sim @ChangUCanSpare @arkanalabs Changes on silver stains are seen in stage II - IV electron dense deposits, with stage II deposits showing spikes and stage III showing holes. In early membranous you may not see any changes on light microscopy but you have deposits seen by IF & EM. #nephjc |
| Ross Morton @signindoc RT @poyanmehr: What have you been using for primary induction of severe primary MN? If you pick CTX, reach@out to @fervenzafernan1 so he can pick you as a site for his next trial #NephJC |
| Poyan Mehr @poyanmehr @fervenzafernan1 My impression is that the modified Ponticelli is the one most are using. So you would have a good following here #NephJC |
| Nikhil Shah MBBS DNB(IM, Neph)🇨🇦 @dr_nikhilshah #NephPearls #Membranous #MENTOR #nephjc |
| Verner Venegas @Vernisartan RT @fervenzafernan1: @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| fernando fervenza @fervenzafernan1 RT @poyanmehr: @fervenzafernan1 My impression is that the modified Ponticelli is the one most are using. So you would have a good following here #NephJC |
| Alex Meraz @NephroGuy Did anybody mention the biggest win of #MENTOR IMO... NO STEROID USE!!! The biggest side effects I have side are directly related to these amazing and dangerous drugs #NephJC |
| Laurence H Beck, Jr @LaurenceHBeckJ1 @fervenzafernan1 @Maximal_Change Thank you Fernando and all the authors for this amazing study! The patients will thank you as well! Good night #NephJC! |
| Juan Carlos Q Velez @VelezNephHepato RT @fervenzafernan1: @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| Poyan Mehr @poyanmehr RT @rheault_m: @fervenzafernan1 @LaurenceHBeckJ1 @Maximal_Change Nephrology research is a team sport. Anyone who thinks they can do it on their own is wrong. Keep up the collaborations. #NephJC |
 | Suneel Udani @CaptainKidney79 RT @Maximal_Change: @DrRaymondHsu @NephJC That’s about standard with other cohorts looking at primary membranous. About 30% pts are PLa2R ab negative. It’s not the only antibody #NephJC |
| Alex Meraz @NephroGuy @BetterCallSeeth Now that is a combo that I have never used. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @NephJC: Thank you all for joining the conversation about the MENTOR study and making this #NephJC chat great! Special shout out to the authors, GN experts, and trainees! Don’t forget we have two additional chats coming up July 10, 9 pm India ST and 9 pm British ST. Good night! |
| Suneel Udani @CaptainKidney79 RT @hswapnil: Just for Ali 🤔#NephJC @poyanmehr |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @fervenzafernan1: @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| Suneel Udani @CaptainKidney79 RT @rheault_m: @poyanmehr @fervenzafernan1 @NephJC Possibly. Labeling makes a huge difference for insurance approval however. Would save time writinng prior auth letters #NephJC |
| Juan Carlos Q Velez @VelezNephHepato Fantastic |
| Mohamed E. Elrggal @M_Elraggal RT @fervenzafernan1: @poyanmehr Cyclophosphamide works. No question. The issue is that not everyone know how to use it safely. And when I use with prednisone I do as a modified Ponticelli: 20 mg a day together with cyclophosphamide, and only 1 dose of MTP at start #nephjc |
| Laurence H Beck, Jr @LaurenceHBeckJ1 #NephJC |
| Poyan Mehr @poyanmehr @NephroGuy @LaurenceHBeckJ1 @NephJC There are a couple case reports and a case series on bortezomib in severe therapy resistant MN #nephJC |
| Alex Meraz @NephroGuy RT @LaurenceHBeckJ1: @M_Elraggal Jon Hogan at Penn had a great case that he will hopefully write up, and Beppe Remuzzi is very interested in use of anti-CD38 in MN. #NephJC |
| Raja Ramachandran (राजा) @raja_1980 @VelezNephHepato @kidneydoc101 @NephroMD @LaurenceHBeckJ1 The problem with using a very short course of CYC/GC is the relapse following stopping the drug (We have tried it). The results may not be the same as Std Tx. But, for a 70 Kg, total CYC in Mod Ponti will be 12-13 g only. #NephJC |
| Swapnil Hiremath @hswapnil@bsky.social @hswapnil RT @poyanmehr: @fervenzafernan1 My impression is that the modified Ponticelli is the one most are using. So you would have a good following here #NephJC |
| Nephrology Journal Club @NephJC RT @kidneybiz: @BeheraVineet @fervenzafernan1 @LaurenceHBeckJ1 @hswapnil @kidney_boy No superiority of tacrolimus vs . cyclosporine, and most North American docs felt they and patients would not accept comparison treatment with cyclophosphamide. Dan's (Cattran)experience with cyclosporine pretty compelling for reasonably effective, safe agent to use. #nephJC |
| Nephrology Journal Club @NephJC RT @LaurenceHBeckJ1: @Maximal_Change @Furqi @christhero10 @hswapnil @poyanmehr Was only part of initial interviews by study, but most US and Canadian centers feel more comfortable treating with CNI. Too many SAE with alkylating agents. #NephJC |
| Nephrology Journal Club @NephJC RT @ssfarouk: @hswapnil @PabloGarciaMD @NephJC @kidneybiz @fervenzafernan1 Supplement FTW #NephJC |
| Nephrology Journal Club @NephJC RT @HecmagsMD: #nephjc |
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