In membranous nephropathy, which immunosuppressive approach is described as prednisone plus another agent?

• A. Prednisone alone
• B. Prednisone plus cyclophosphamide
• C. Prednisone plus methotrexate
• D. Azathioprine alone

Answer: (B)

In membranous nephropathy, the treatment goal is to suppress the autoimmune process that drives the disease. The classic immunosuppressive approach described as prednisone plus another agent is prednisone combined with cyclophosphamide. Cyclophosphamide is an alkylating agent that dampens B-cell activity and antibody production, while prednisone provides broad immunosuppression and anti-inflammatory effects. Together, they reduce the formation of pathogenic immune complexes along the glomerular basement membrane and help decrease proteinuria. Other options like prednisone alone, azathioprine alone, or prednisone with methotrexate aren’t the standard combination described for this condition.