Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study

ObjectiveThis study aimed to evaluate the efficacy and safety of obinutuzumab, a novel anti-CD20 monoclonal antibody, in patients with primary membranous nephropathy (pMN).MethodsFifty-five patients with pMN treated with obinutuzumab were respectively enrolled in this study. Clinical and immunologic...

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Main Authors: Xi Cheng, Zhen-feng Zheng, Yan Qi, Xin Cao, Xi-qian Gao, Ying-xin Fang, Li Wei, Wen-ya Shang, Tie-kun Yan, Jun-ya Jia, Peng-cheng Xu, Qiu-hua Gu
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Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1650054/full
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author Xi Cheng
Zhen-feng Zheng
Yan Qi
Xin Cao
Xi-qian Gao
Ying-xin Fang
Li Wei
Wen-ya Shang
Tie-kun Yan
Jun-ya Jia
Peng-cheng Xu
Qiu-hua Gu
author_facet Xi Cheng
Zhen-feng Zheng
Yan Qi
Xin Cao
Xi-qian Gao
Ying-xin Fang
Li Wei
Wen-ya Shang
Tie-kun Yan
Jun-ya Jia
Peng-cheng Xu
Qiu-hua Gu
author_sort Xi Cheng
collection DOAJ
description ObjectiveThis study aimed to evaluate the efficacy and safety of obinutuzumab, a novel anti-CD20 monoclonal antibody, in patients with primary membranous nephropathy (pMN).MethodsFifty-five patients with pMN treated with obinutuzumab were respectively enrolled in this study. Clinical and immunological response, renal function and adverse events were assessed throughout the follow-up period between patients receiving obinutuzumab as initial therapy and alternative therapy.ResultsThe study included 40 patients receiving obinutuzumab as an alternative therapy, and 15 patients receiving it as an initial therapy. During a follow up of 13.0(10.0, 18.0) months after obinutuzumab treatment, 23/25(92.0%) patients achieved immunological remission. 46/55(83.6%) patients achieved clinical remission (including 40.0% of PR and 43.6% of CR), with significantly reduced proteinuria and increased serum albumin. Patients with obinutuzumab as either the initial or alternative treatment showed similar clinical response (85.0 vs. 80.0%, P=0.692). 13 out of 18 patients (72.2%) with impaired kidney function (eGFR <60 mL/min/1.73 m²) also showed significant response to obinutuzumab, along with eGFR increasing from 35.3 to 47.6 mL/min/1.73m². Furthermore, obinutuzumab also had a comparable efficiency in patients without response to previous rituximab treatment and patients with negative anti-PLA2R antibody. More patients in the initial therapy group had infusion-related reactions (33.3 vs. 15.0%, P=0.149), while severe infections were all occurred in the alternative therapy group, particularly those with a history of long-term immunosuppressive therapy.ConclusionsObinutuzumab, used as both initial and alternative therapy, can induce significant clinical response in patients with pMN, implying its potentially promising therapeutic effect on pMN.
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spelling doaj-art-df0375ec2e9f47199d58e86c8502c9092025-08-21T05:27:06ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16500541650054Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective studyXi Cheng0Zhen-feng Zheng1Yan Qi2Xin Cao3Xi-qian Gao4Ying-xin Fang5Li Wei6Wen-ya Shang7Tie-kun Yan8Jun-ya Jia9Peng-cheng Xu10Qiu-hua Gu11Department of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, ChinaDepartment of Nephrology, Tianjin Medical University General Hospital Airport Hospital, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaDepartment of Nephrology, Kidney Disease Medical Center, Tianjin Medical University General Hospital, National Key Clinical Specialty, Tianjin Key Medical Discipline, Tianjin, ChinaObjectiveThis study aimed to evaluate the efficacy and safety of obinutuzumab, a novel anti-CD20 monoclonal antibody, in patients with primary membranous nephropathy (pMN).MethodsFifty-five patients with pMN treated with obinutuzumab were respectively enrolled in this study. Clinical and immunological response, renal function and adverse events were assessed throughout the follow-up period between patients receiving obinutuzumab as initial therapy and alternative therapy.ResultsThe study included 40 patients receiving obinutuzumab as an alternative therapy, and 15 patients receiving it as an initial therapy. During a follow up of 13.0(10.0, 18.0) months after obinutuzumab treatment, 23/25(92.0%) patients achieved immunological remission. 46/55(83.6%) patients achieved clinical remission (including 40.0% of PR and 43.6% of CR), with significantly reduced proteinuria and increased serum albumin. Patients with obinutuzumab as either the initial or alternative treatment showed similar clinical response (85.0 vs. 80.0%, P=0.692). 13 out of 18 patients (72.2%) with impaired kidney function (eGFR <60 mL/min/1.73 m²) also showed significant response to obinutuzumab, along with eGFR increasing from 35.3 to 47.6 mL/min/1.73m². Furthermore, obinutuzumab also had a comparable efficiency in patients without response to previous rituximab treatment and patients with negative anti-PLA2R antibody. More patients in the initial therapy group had infusion-related reactions (33.3 vs. 15.0%, P=0.149), while severe infections were all occurred in the alternative therapy group, particularly those with a history of long-term immunosuppressive therapy.ConclusionsObinutuzumab, used as both initial and alternative therapy, can induce significant clinical response in patients with pMN, implying its potentially promising therapeutic effect on pMN.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1650054/fullmembranous nephropathyobinutuzumabrituximabanti-phospholipase A2 receptor antibodyrenal function
spellingShingle Xi Cheng
Zhen-feng Zheng
Yan Qi
Xin Cao
Xi-qian Gao
Ying-xin Fang
Li Wei
Wen-ya Shang
Tie-kun Yan
Jun-ya Jia
Peng-cheng Xu
Qiu-hua Gu
Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study
Frontiers in Immunology
membranous nephropathy
obinutuzumab
rituximab
anti-phospholipase A2 receptor antibody
renal function
title Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study
title_full Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study
title_fullStr Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study
title_full_unstemmed Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study
title_short Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective study
title_sort efficacy and safety of obinutuzumab in primary membranous nephropathy a real world retrospective study
topic membranous nephropathy
obinutuzumab
rituximab
anti-phospholipase A2 receptor antibody
renal function
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1650054/full
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