Jha Vijoy Kumar, Panda Sanjay Kumar, Rai Shailendra Kumar, Srivastava Atul Kumar
Department of Nephrology, Base Hospital, New Delhi, Delhi Cantt, India.
Department of Medicine, Base Hospital, New Delhi, Delhi Cantt, India.
Indian J Nephrol. 2025 Jan-Feb;35(1):91-96. doi: 10.25259/ijn_498_23. Epub 2024 Jul 8.
Obinutuzumab is a glycoengineered type II anti-CD20 monoclonal antibody with superior B cell cytotoxicity compared to rituximab. Various case reports suggest that in refractory phospholipase A2 receptor (PLA2R) positive membranous nephropathy (MN) patients, Obinutuzumab led to immunologic remission and improvement in proteinuria. In the present case series, we present six cases of difficult-to-treat PLA2R-associated MN refractory to prednisolone, calcineurin inhibitor (CNI), cyclophosphamide, and rituximab but subsequently responded to Obinutuzumab. Five out of six cases showed partial /complete clinical remission and immunological remission (IR) with normalization of serum albumin and stable renal function. Though this drug's long-term efficacy and impact remain unclear, it is being increasingly considered for PLA2R-associated MN resistant to standard therapy.
奥妥珠单抗是一种糖基化工程改造的II型抗CD20单克隆抗体，与利妥昔单抗相比，具有更强的B细胞细胞毒性。各种病例报告表明，在难治性磷脂酶A2受体（PLA2R）阳性膜性肾病（MN）患者中，奥妥珠单抗可导致免疫缓解和蛋白尿改善。在本病例系列中，我们报告了6例难治性PLA2R相关MN患者，这些患者对泼尼松龙、钙调神经磷酸酶抑制剂（CNI）、环磷酰胺和利妥昔单抗均无反应，但随后对奥妥珠单抗有反应。6例患者中有5例实现了部分/完全临床缓解和免疫缓解（IR），血清白蛋白恢复正常，肾功能稳定。尽管这种药物的长期疗效和影响尚不清楚，但对于标准治疗耐药的PLA2R相关MN，越来越多的人考虑使用它。
