■膜性肾病(MN),被认为是一种自身免疫性肾病,抗CD20单克隆抗体反应良好。奥比努珠单抗,一种Ⅱ型人源化抗CD20和免疫球蛋白G1Fc优化的单克隆抗体,与利妥昔单抗相比,在B细胞白血病和淋巴瘤中表现出优异的疗效,尤其是利妥昔单抗耐药病例。然而,奥比努珠单抗在MN中的疗效和安全性尚不清楚.
■案例系列研究。
■共有18例患者被诊断为MN,并在我们中心接受了奥比努珠单抗,但没有继发性MN,正在接受透析,有肾移植史,或需要治疗的感染。
■奥比妥珠单抗治疗。
■主要结果包括缓解率,第一次缓解的时间,随访期间首次无复发生存时间。
■使用Cox比例风险模型进行生存分析,对数秩检验,和Kaplan-Meier生存分析。
■MN患者(中位年龄52.5岁,83.3%的男性)在13.6个月的中位随访期内接受了平均剂量为2.1±0.8g的obinutuzumab。在后续行动中,17例患者(94.4%)获得缓解,12例(66.7%)部分缓解,5例(27.8%)完全缓解。首次缓解和首次无复发生存时间的中位数分别为2.7(1.0-6.1)个月和9.8(2.6-11.2)个月,分别。在12名以前接受过利妥昔单抗治疗的患者中,都成功实现了缓解,8(66.7%)实现部分缓解,4(33.3%)实现完全缓解。不良事件大多是轻度的,未观察到严重的治疗相关不良事件.
■数据有限或缺失;选择偏倚的风险;或回忆偏倚;由于随访时间有限,首次无复发生存时间被低估;未监测的CD19+B细胞和其他淋巴细胞亚群计数。
■奥比努珠单抗在诱导MN缓解方面表现出了有希望的疗效和安全性,特别是对利妥昔单抗反应不满意的患者。
膜性肾病(MN),自身免疫性肾病,通常对利妥昔单抗反应良好,嵌合抗CD20单克隆抗体。然而,某些患者对利妥昔单抗的反应不足.奥比努珠单抗,一种新型人源化抗CD20单克隆抗体,在利妥昔单抗无法解决B细胞白血病和淋巴瘤的情况下,显示出增强的疗效。然而,其在MN治疗中的有效性和安全性仍不确定。我们中心的一组病例包括18例接受奥比努珠单抗治疗的患者,结果很有希望。提示在诱导和维持缓解方面具有良好的疗效和安全性,尤其是以前对利妥昔单抗反应不佳的患者.这些发现标志着MN治疗的潜在替代方案,尽管需要进一步的研究来证实它们。
UNASSIGNED: Membranous nephropathy (MN), recognized as an autoimmune kidney disease, responds well to anti-CD20 monoclonal antibodies.
Obinutuzumab, a type Ⅱ humanized anti-CD20 and immunoglobulin G1 Fc-optimized monoclonal antibody, when compared with rituximab, has demonstrated superior efficacy in B-cell leukemia and lymphoma, especially in rituximab-resistant cases. However, the efficacy and safety of
obinutuzumab in MN remain unclear.
UNASSIGNED: A case series study.
UNASSIGNED: A total of 18 patients were diagnosed with MN and had received
obinutuzumab at our center without secondary MN, undergoing dialysis, having a history of kidney transplantation, or infections requiring treatment.
UNASSIGNED: Obinutuzumab treatment.
UNASSIGNED: Primary outcomes included remission rate, time to first remission, and first relapse-free survival time during the follow-up period.
UNASSIGNED: Survival analysis was performed with Cox proportional hazards models, log-rank test, and Kaplan-Meier survival analysis.
UNASSIGNED: Patients with MN (median age of 52.5 years, 83.3% males) received an average dose of 2.1 ± 0.8 g of obinutuzumab during a median follow-up period of 13.6 months. During the follow-up, 17 patients (94.4%) achieved remission, with 12 patients (66.7%) achieving partial remission, and 5 patients (27.8%) achieving complete remission. The median time to first remission and first relapse-free survival time was 2.7 (1.0-6.1) months and 9.8 (2.6-11.2) months, respectively. Of 12 patients with previous rituximab treatment, all achieved remission successfully, with 8 (66.7%) achieving partial remission and 4 (33.3%) achieving complete remission. Adverse events were mostly mild, and no severe treatment-related adverse events were observed.
UNASSIGNED: Limited or missing data; risks of selection bias; or recall bias; underestimated first relapse-free survival time because of a limited follow-up period; unmonitored counts of CD19+ B-cells and other lymphocyte subsets.
UNASSIGNED: Obinutuzumab demonstrated promising efficacy and safety in inducing remission in MN, particularly in patients with an unsatisfactory response to rituximab.
Membranous nephropathy (MN), an autoimmune kidney disease, usually responds favorably to rituximab, a chimeric anti-CD20 monoclonal antibody. Nevertheless, certain patients exhibit inadequate responses to rituximab. Obinutuzumab, a novel humanized anti-CD20 monoclonal antibody, has shown enhanced efficacy in cases where rituximab fails to address B-cell leukemias and lymphomas. However, its efficacy and safety in MN treatment remain uncertain. A case series involving 18 patients treated with obinutuzumab at our center demonstrated promising results, suggesting favorable efficacy and safety in inducing and maintaining remission, particularly among patients who did not respond well to rituximab previously. These findings signify a potential alternative for MN treatment, though further research is needed to confirm them.