FIRST-AND SECOND-LINE THERAPY OF ZUBERITAMAB IN IDIOPATHIC MEMBRANOUS NEPHROPATHY: A SINGLE-CENTER RETROSPECTIVE STUDY

Introduction:

Idiopathic membranous nephropathy (IMN) is a leading cause of nephrotic syndrome. While rituximab has significantly improved outcomes for patients with IMN, its efficacy is not universal, and resistance is common. Zuberitamab, an innovative anti-CD20 IgG1 monoclonal antibody, has shown promise in reducing proteinuria in IMN, though follow-up data are limited.

Methods:

We conducted a study involving patients with PLA2R-associated IMN who were treated with zuberitamab. 19(90.5%) patients received 2g dose ，1(4.76%) received 3g dose and 1(4.76%) received 1g dose . The median follow-up period was 6.5 months (interquartile range, 6-7.5 months). Patients were evaluated at 15 days, 3 months, and 6 months after zuberitamab administration, with serial monitoring of serum albumin, 24-hour proteinuria, renal function, PLA2R-Ab titers, and circulating CD19+ B cells. Complete and partial remission of proteinuria were compared at 3 and 6 months.

Results:

Zuberitamab was used as first-line therapy in 10 patients, while another 11 patients, received zuberitamab as second-line therapy following previous immunosuppressive treatments. At month 3, 18 patients (85.7%) achieved either complete (n=4; 2 in the first-line group and 2 in the second-line group, P=1.00) or partial (n=14; 7 in the first-line group and 7 in the second-line group, P=1.00) remission. By month 6, the same 18 patients (85.7%) were in remission, with 9 achieving complete remission (5 in the first-line group and 4 in the second-line group, P=1.00) and 9 achieving partial remission (4 in the first-line group and 5 in the second-line group , P=1.00). Serum albumin levels increased, while proteinuria and serum creatinine levels decreased in both groups at all time points (15 days, 3 months, and 6 months). The rates of PLA2R-Ab depletion (<2 RU/mL) in the first-line and second-line groups were 0 of 8 and 6 of 8 (75.0%) at day 15 (P=0.007), 6 of 8 (75.0%) and 8 of 8 (100%) at month 3 (P=0.467), and 8 of 8 (100%) in both groups at month 6 (P=1.000). No serious adverse events were observed in either group.

Conclusions:

Zuberitamab shows significant effectiveness and favorable safety in the clinical treatment of IMN. It represents a promising therapeutic option for Chinese patients with IMN. 

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.