Objective:

To investigate the efficacy and safety of obinutuzumab in treating various subtypes of primary membranous nephropathy (PMN).

Approach:

• Study Design: A total of 94 PMN patients with nephrotic syndrome were enrolled and categorized into three groups based on treatment history: Initial therapy group (group A), Refractory group (group B), and Remedial therapy group (group C).
• Endpoints: The primary endpoint was the clinical remission rate at 24 months, while secondary endpoints included treatment safety and incidence of treatment-emergent adverse events.

Key Findings:

• 95.74% of PMN patients achieved clinical remission after 24 months of obinutuzumab therapy, with 28.72% reaching complete remission and 67.02% achieving partial remission.
• The Initial therapy group (group A) had a 100% clinical remission rate, with 37.5% attaining complete remission and 62.5% attaining partial remission.
• The Refractory group (group B) achieved a 96.88% clinical remission rate, with 25% attaining complete remission and 71.88% attaining partial remission.
• The Remedial therapy group (group C) had a 90% clinical remission rate, with 23.33% attaining complete remission and 66.67% attaining partial remission.
• All anti-PLA2R antibody-positive patients showed declining antibody levels, with 68.4% achieving complete immunological remission.

Interpretation:

Conclusion: