eligibility_summary
Eligibility: Patients with nephrotic syndrome and IMN confirmed by biopsy or PLA2R Ab >20 IU/mL, who failed steroids plus cyclophosphamide/other immunosuppressants or rituximab, or have recurrent relapses, and are treated with inotuzumab. Exclude HBV/HCV or LFTs >2×ULN, immunodeficiency or active TB/CMV or severe infection needing IV antibiotics, serious medical/psychiatric illness, congenital heart disease, arrhythmia, heart failure, other major CVD, or malignancy.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Intervention: Obinutuzumab (type II, humanized, glyco‑engineered anti‑CD20 monoclonal antibody) 1000 mg IV, studied in an observational cohort of adults with idiopathic membranous nephropathy (IMN) refractory/relapsing after standard immunosuppression or rituximab. Mechanism: binds a distinct CD20 epitope and depletes CD20+ B cells via enhanced FcγRIIIa‑mediated antibody‑dependent cellular cytotoxicity (NK cells) and antibody‑dependent phagocytosis (macrophages), plus direct apoptosis, relies less on complement‑dependent cytotoxicity than rituximab. Targets/pathways: CD20+ B lymphocytes producing autoantibodies (anti‑PLA2R, anti‑THSD7A), reduces subepithelial IgG/C3 immune complexes on podocytes and complement‑mediated glomerular injury to lower proteinuria.