Abstract: FR-PO0807
Maintenance Regimens of Rituximab for Primary Membranous Nephropathy: A Single-Center Retrospective Analysis of 558 Patients
Session Information
- Glomerular Diseases: Practice and New Concepts Shaping Modern Care
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Author
- Gou, Rong, Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Background
Rituximab (RTX) has emerged as a pivotal therapy for refractory primary membranous nephropathy (PMN), yet standardized maintenance strategies remain undefined. This study aimed to explore the efficacy of different RTX maintenance regimens and their long-term outcomes in PMN patients, so as to optimize individualized maintenance treatment courses and reduce disease relapse.
Methods
This single-center retrospective study included PMN patients treated with RTX between Jan 2017 and Aug 2024 at our center, with follow-up >1 year. Among 1085 identified, A total of 558 patients presented with nephrotic syndrome (NS) at baseline and were stratified into four maintenance groups:no maintenance (24.55%), fixed 6-monthly RTX (34.59%), B-cell-guided (29.39%), anti-PLA2R antibody-guided (8.78%), and proteinuria-guided (2.69%). Remission (complete/partial response, CR/PR) and relapse rates were analyzed at 12 and 24 months.
Results
In the 558 NS patients, overall remission rates at 6, 12, and 24 months were 72.26% (CR 42.95%), 77.88% (CR 58.12%), and 70.41% (CR 56.12%), with relapse rates of 12.17% (12m) and 21.42% (24m).At 12 months:No maintenance: 73.73% remission (CR 43.07%)，Fixed 6-monthly: 70.99% (CR 45.60%)，B-cell-guided: 80.49% (CR 54.88%)，Anti-PLA2R-guided: 46.94% (CR 24.49%).At 24 months:No maintenance: 64.86% (CR 50.00%),Fixed 6-monthly: 77.99% (CR 62.39%),B-cell-guided: 70.42% (CR 60.56%),Anti-PLA2R-guided: 51.61% (CR 32.26%).B-cell-guided achieved highest 12-month remission, while fixed 6-monthly showed superior remission and CR at 24 months. No maintenance was associated with higher relapse rates. Anti-PLA2R-guided group had consistently lower response.
Conclusion
B-cell count-guided maintenance yields better short-term (12-month) response, whereas fixed 6-monthly RTX provides superior medium-term (24-month) outcomes in PMN patients. No maintenance increases relapse risk. Individualized strategies based on immune monitoring are recommended over antibody-guided or no maintenance. Prospective studies are needed to define optimal duration.