eligibility_summary
Adults 18–75 with biopsy-confirmed idiopathic membranous nephropathy or PLA2R+, complete data, KDIGO 2020 moderate/high risk, generally well, communicative, and consented. Exclude secondary MN (SLE, tumors/infections like hepatitis, drugs/toxins), coexisting renal disease (IgAN, interstitial or acute nephritis), nonstandard meds, severe infection/AKI, serious CV/cerebrovascular/GI/hematologic disease, poor cooperation or comprehension.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
NCT05667909 is an observational study in idiopathic membranous nephropathy (IMN) patients treated with rituximab to develop a prognostic model of treatment response. Intervention: Rituximab (biologic, chimeric anti-CD20 monoclonal antibody), given as 375 mg/m2 weekly ×4 or 1 g IV ×2 two weeks apart. Mechanism: Depletes CD20+ B cells (pre-B to mature B cells), lowering pathogenic autoantibody production (notably anti-PLA2R), thereby reducing immune complex deposition on podocytes and downstream complement activation (membrane attack complex), which drives podocyte injury and proteinuria. Targets/cells/pathways: CD20+ B lymphocytes, humoral autoimmunity, PLA2R-directed immune complexes at the podocyte, complement-mediated glomerular damage. The study compares remission vs non-remission groups and explores whether gut microbiota and metabolites modulate rituximab efficacy.