{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T22:52:45Z","timestamp":1794264765907,"version":"4.9.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the efficacy and safety of obinutuzumab, a novel anti-CD20 monoclonal antibody, in patients with primary membranous nephropathy (pMN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty-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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 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%, <jats:italic>P<\/jats:italic>=0.692). 13 out of 18 patients (72.2%) with impaired kidney function (eGFR &amp;lt;60 mL\/min\/1.73 m\u00b2) also showed significant response to obinutuzumab, along with eGFR increasing from 35.3 to 47.6 mL\/min\/1.73m\u00b2. 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%, <jats:italic>P<\/jats:italic>=0.149), while severe infections were all occurred in the alternative therapy group, particularly those with a history of long-term immunosuppressive therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Obinutuzumab, used as both initial and alternative therapy, can induce significant clinical response in patients with pMN, implying its potentially promising therapeutic effect on pMN.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1650054","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T05:27:17Z","timestamp":1755754037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy and safety of obinutuzumab in primary membranous nephropathy: a real-world retrospective 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