Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial
Xue-Qi Li,1 Yang Liu,1 Ze-Yu Cai,1 Tie-Gang Lv,2 Jian Hao1 1Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010050, China; 2Department of Medicine, Division of Radiology, The Affiliated Hospital o...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-07-01
|
| Series: | Drug Design, Development and Therapy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/obinutuzumab-is-effective-as-an-initial-treatment-for-pla2r-associated-peer-reviewed-fulltext-article-DDDT |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849721156654858240 |
|---|---|
| author | Li XQ Liu Y Cai ZY Lv TG Hao J |
| author_facet | Li XQ Liu Y Cai ZY Lv TG Hao J |
| author_sort | Li XQ |
| collection | DOAJ |
| description | Xue-Qi Li,1 Yang Liu,1 Ze-Yu Cai,1 Tie-Gang Lv,2 Jian Hao1 1Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010050, China; 2Department of Medicine, Division of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010050, People’s Republic of ChinaCorrespondence: Jian Hao, Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 North Passage Road, Huimin District, Hohhot, Inner Mongolia Autonomous Region, 010050, People’s Republic of China, Tel +8613704751021, Email jian_hao8865@126.comBackground: Membranous nephropathy (MN) can cause nephrotic syndrome. B cells contribute to MN, but available treatments are often inadequate. We addressed this treatment gap by analyzing the effect of obinutuzumab in patients with primary MN (PMN).Methods: Forty-seven PMN patients were followed for six months, with 25 receiving obinutuzumab and 22 (control) receiving rituximab. Treatment response was assessed by 24-h urine total protein (24-h UTP), serum albumin (ALB), and other indicators. Immunologic remission was assessed by measurement of anti-phospholipase A2 receptor autoantibodies (PLA2R autoAbs).Results: Relative to baseline, the obinutuzumab group had significant decreases of PLA2R autoAbs (83.40 [55.90– 344.36] vs 0.41 [0.17– 1.20] RU/mL), 24-h UTP (8.90 [7.15– 13.80) vs 1.82 [1.12– 3.43] g/day), and B cells (312.61 [202.00– 406.12) vs 0 [0– 0] cells/μL), and a significant increase of serum ALB (25.90 [20.85– 28.70] vs 42 [39.7– 45.3] g/L) after six months. Nineteen of the evaluable patients (76% [55– 91%]) achieved immunological remission at three months, 20 (80% [60– 93%] achieved immunological remission at six months, and 16 (64% [42– 83%] achieved partial response (PR) at three-months. After six-months, no patients achieved complete remission, but 19 (76% [55– 91%]) achieved PR. Before the second dose of obinutuzumab, the CD19+ B cell count in 20 patients (80%) [60%– 93%] was less than 1 cell/μL, and 18 patients had counts of 0 cells/μL. At the 6-month follow-up, the rituximab and obinutuzumab groups had no significant differences in immunological remission (80% vs 64%; OR: 2.29 [0.62– 8.47]; P=0.211) or clinical remission (76% vs 59%; OR: 2.19 [0.63– 7.66]; P=0.215]. No patients experienced serious adverse events.Conclusion: This retrospective analysis suggests that obinutuzumab may have potential as an initial therapeutic option for patients with PMN, although larger controlled studies are needed for confirmation.Keywords: obinutuzumab, PLA2R, membranous nephropathy, proteinuria |
| format | Article |
| id | doaj-art-bfde803474a94013a11cc8d1e116ba0f |
| institution | DOAJ |
| issn | 1177-8881 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Drug Design, Development and Therapy |
| spelling | doaj-art-bfde803474a94013a11cc8d1e116ba0f2025-08-20T03:11:45ZengDove Medical PressDrug Design, Development and Therapy1177-88812025-07-01Volume 19Issue 159615972104720Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center TrialLi XQ0Liu Y1Cai ZY2Lv TG3Hao J4Department of Medicine, Division of NephrologyDepartment of Medicine, Division of NephrologyDepartment of Medicine, Division of NephrologyDepartment of Medicine, Division of RadiologyDepartment of Medicine, Division of NephrologyXue-Qi Li,1 Yang Liu,1 Ze-Yu Cai,1 Tie-Gang Lv,2 Jian Hao1 1Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010050, China; 2Department of Medicine, Division of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia Autonomous Region, 010050, People’s Republic of ChinaCorrespondence: Jian Hao, Department of Medicine, Division of Nephrology, The Affiliated Hospital of Inner Mongolia Medical University, No. 1 North Passage Road, Huimin District, Hohhot, Inner Mongolia Autonomous Region, 010050, People’s Republic of China, Tel +8613704751021, Email jian_hao8865@126.comBackground: Membranous nephropathy (MN) can cause nephrotic syndrome. B cells contribute to MN, but available treatments are often inadequate. We addressed this treatment gap by analyzing the effect of obinutuzumab in patients with primary MN (PMN).Methods: Forty-seven PMN patients were followed for six months, with 25 receiving obinutuzumab and 22 (control) receiving rituximab. Treatment response was assessed by 24-h urine total protein (24-h UTP), serum albumin (ALB), and other indicators. Immunologic remission was assessed by measurement of anti-phospholipase A2 receptor autoantibodies (PLA2R autoAbs).Results: Relative to baseline, the obinutuzumab group had significant decreases of PLA2R autoAbs (83.40 [55.90– 344.36] vs 0.41 [0.17– 1.20] RU/mL), 24-h UTP (8.90 [7.15– 13.80) vs 1.82 [1.12– 3.43] g/day), and B cells (312.61 [202.00– 406.12) vs 0 [0– 0] cells/μL), and a significant increase of serum ALB (25.90 [20.85– 28.70] vs 42 [39.7– 45.3] g/L) after six months. Nineteen of the evaluable patients (76% [55– 91%]) achieved immunological remission at three months, 20 (80% [60– 93%] achieved immunological remission at six months, and 16 (64% [42– 83%] achieved partial response (PR) at three-months. After six-months, no patients achieved complete remission, but 19 (76% [55– 91%]) achieved PR. Before the second dose of obinutuzumab, the CD19+ B cell count in 20 patients (80%) [60%– 93%] was less than 1 cell/μL, and 18 patients had counts of 0 cells/μL. At the 6-month follow-up, the rituximab and obinutuzumab groups had no significant differences in immunological remission (80% vs 64%; OR: 2.29 [0.62– 8.47]; P=0.211) or clinical remission (76% vs 59%; OR: 2.19 [0.63– 7.66]; P=0.215]. No patients experienced serious adverse events.Conclusion: This retrospective analysis suggests that obinutuzumab may have potential as an initial therapeutic option for patients with PMN, although larger controlled studies are needed for confirmation.Keywords: obinutuzumab, PLA2R, membranous nephropathy, proteinuriahttps://www.dovepress.com/obinutuzumab-is-effective-as-an-initial-treatment-for-pla2r-associated-peer-reviewed-fulltext-article-DDDTObinutuzumabPLA2Rmembranous nephropathyproteinuria |
| spellingShingle | Li XQ Liu Y Cai ZY Lv TG Hao J Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial Drug Design, Development and Therapy Obinutuzumab PLA2R membranous nephropathy proteinuria |
| title | Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial |
| title_full | Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial |
| title_fullStr | Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial |
| title_full_unstemmed | Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial |
| title_short | Obinutuzumab is Effective as an Initial Treatment for PLA2R-Associated Primary Membranous Nephropathy: A Retrospective, Single-Center Trial |
| title_sort | obinutuzumab is effective as an initial treatment for pla2r associated primary membranous nephropathy a retrospective single center trial |
| topic | Obinutuzumab PLA2R membranous nephropathy proteinuria |
| url | https://www.dovepress.com/obinutuzumab-is-effective-as-an-initial-treatment-for-pla2r-associated-peer-reviewed-fulltext-article-DDDT |
| work_keys_str_mv | AT lixq obinutuzumabiseffectiveasaninitialtreatmentforpla2rassociatedprimarymembranousnephropathyaretrospectivesinglecentertrial AT liuy obinutuzumabiseffectiveasaninitialtreatmentforpla2rassociatedprimarymembranousnephropathyaretrospectivesinglecentertrial AT caizy obinutuzumabiseffectiveasaninitialtreatmentforpla2rassociatedprimarymembranousnephropathyaretrospectivesinglecentertrial AT lvtg obinutuzumabiseffectiveasaninitialtreatmentforpla2rassociatedprimarymembranousnephropathyaretrospectivesinglecentertrial AT haoj obinutuzumabiseffectiveasaninitialtreatmentforpla2rassociatedprimarymembranousnephropathyaretrospectivesinglecentertrial |