Abstract: SA-PO0807
Additional Doses of Rituximab at Month 3 Improve Complete Remission Rates in Primary Membranous Nephropathy (MN): Propensity Score Matching Analysis
Session Information
- Glomerular Management: Real-World Lessons and Emerging Therapies
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Sun, Yao, Southeast University, Nanjing, Jiangsu, China
- Wang, Yujia, Nanjing University, Nanjing, Jiangsu, China
- Liu, Jing, Nanjing University, Nanjing, Jiangsu, China
- Wu, Min, Southeast University, Nanjing, Jiangsu, China
- Tang, Rining, Nanjing University, Nanjing, Jiangsu, China
Background
Rituximab is recommended by KDIGO as a first-line treatment for Primary Membranous Nephropathy. However, standard dosing may be impacted by rapid clearance from proteinuria and anti-drug antibodies. This study investigates the impact of an additional RTX dose at month three on remission in PMN patients.
Methods
This retrospective study screened 153 PMN patients from our center. After 1:1 propensity score matching, patients were divided into a modified interval dosing group (Modified RTX, n=21) and a standard dosing group (Standard RTX, n=21). The MRTX group received rituximab 375mg/m2 on days 1, 15, 30, and 90, while the SRTX group received weekly rituximab 375mg/m2for 4 consecutive weeks. Patients were followed for 12 months with complete remission rate and proteinuria level as primary endpoints.
Results
After matching, baseline characteristics were similar between groups. At 12 months, the MRTX group had higher complete remission rates (71.43% vs 28.57%;P=0.005) and lower proteinuria (0.08 vs 0.50 g/24h;P=0.005). Total remission rates were 95.24% vs 80.95%. Kaplan-Meier analysis showed a higher cumulative probability of complete remission in the MRTX group (P=0.008). At 6 months, the MRTX group had higher serum drug concentrations (6.88 vs 0.07 μg/mL;P=0.035), better maintenance of effective concentration (57.9% vs 26.3%; P=0.099), and no anti-rituximab antibodies (0% vs 11.10%;P=0.229). Relapse occurred only in the SRTX group (0% vs 23.81%; P=0.006), and immunological remission was higher in the MRTX group (57.1% vs 19.1%;P=0.011).
Conclusion
An additional rituximab dose at month three improves 12-month remission rates, maintains effective drug levels, reduces antibody risk, and lowers relapse, offering a safe and effective option for PMN treatment.
Pharmacokinetic and Immunogenicity Analysis at 6 Months
Kaplan-Meier Survival Curves
Funding
- Clinical Revenue Support