Obinutuzumab treatment for membranous nephropathy: effectiveness and safety concerns during the COVID-19 pandemic

作者：Mingyue Xu, Ruiying Chen, Yifeng Wang, Xiaoyun Huang, Hanzhen Zhang, Wenqian Zhao, Min Zhang, Yunyu Xu, Shaojun Liu, Chuan‐Ming Hao, Qionghong Xie · 发表于：Clinical Kidney Journal · 年份：2024 · DOI：10.1093/ckj/sfae299 · 被引用次数：10 · 研究领域：Renal Diseases and Glomerulopathies、COVID-19 Clinical Research Studies、SARS-CoV-2 and COVID-19 Research

ABSTRACT Background Obinutuzumab is a humanized and glycoengineered anti-CD20 monoclonal antibody that has been shown to induce more profound B-cell depletion than rituximab. The effectiveness and safety of obinutuzumab in the treatment of membranous nephropathy remain unclear. Methods This was a retrospective study conducted in Huashan Hospital, Fudan University between 1 December 2021 and 30 November 2023. Patients with membranous nephropathy were included to assess the effectiveness and safety of obinutuzumab and prevalence of severe pneumonia during the outbreak of COVID-19 in China. Results Eighteen patients were included in the study assessing the effectiveness of obinutuzumab. After a 12-month follow-up, 14 patients (78%) achieved remission, with six (33%) achieving complete remission and eight (44%) achieving partial remission. Among the 18 obinutuzumab-treated patients contracting COVID-19 for the first time, six (33%) developed severe pneumonia, and one died. By contrast, two of the 37 patients receiving glucocorticoids combined with cyclophosphamide, and none of the 44 patients on calcineurin inhibitors or the 46 patients on rituximab developed severe pneumonia. However, compared to patients receiving rituximab or glucocorticoids plus cyclophosphamide, the obinutuzumab-treated patients had a longer duration of membranous nephropathy and immunosuppressive therapy. Therefore, cardinal matching was employed to balance these baseline characteristics. Owing to small sam...