Obinutuzumab for membranous nephropathy: a systematic review using pooled case-level extraction analysis
ACTA CLINICA BELGICA, vol.81, no.3, pp.280-292, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 81 Issue: 3
- Publication Date: 2026
- Doi Number: 10.1080/17843286.2026.2642796
- Journal Name: ACTA CLINICA BELGICA
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Page Numbers: pp.280-292
- Keywords: Membranous nephropathy, obinutuzumab, B-cell-directed therapy, nephrotic syndrome
- Dokuz Eylül University Affiliated: Yes
Abstract
BackgroundObinutuzumab has increasingly been used in patients with PLA2R-associated membranous nephropathy (MN). However, reported outcomes vary substantially across studies due to heterogeneity in patient selection, response definitions, and follow-up duration. This study aimed to synthesize case-level extraction analysis to better characterize response patterns and factors influencing remission rates.MethodsMEDLINE, Web of Science, SCOPUS, and grey literature were systematically searched. Case-level extraction analysis from eligible case reports and case series were synthesized to evaluate clinical and immunological remission.ResultsEighty-nine patients from 19 publications were included. Most patients (64%) were reported from China. During a median follow-up of 12 months, overall clinical and immunological remission rates were 83% and 88.7%, respectively. Complete remission was numerically less frequent in patients refractory to prior immunosuppressive therapy compared with those who had previously responded (23.5% vs. 61.5%; nominal p = 0.012). Clinical remission appeared more common among patients followed for at least 12 months (92.6% vs. 75%; nominal p = 0.026). Geographic variation in reported outcomes was noted and appeared to be influenced by differences in follow-up duration and publication type. Adverse events were inconsistently reported; when reported, they were predominantly mild to moderate.ConclusionThis descriptive case-level extraction analysis is consistent with previous small series reporting relatively high clinical remission rates for obinutuzumab in PLA2R-associated MN. The observed remission rates may be influenced by prior treatment responsiveness and duration of follow-up.