Abstract: FR-PO0806
Occurrence and Clinical Effect of Obinutuzumab Antibodies in Patients with Membranous Nephropathy Treated with Obinutuzumab
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
Authors
- Teisseyre, Maxime, Centre Hospitalier de Nice, Nice, France
- Brglez, Vesna, Centre Hospitalier de Nice, Nice, France
- Seitz-Polski, Barbara, Centre Hospitalier de Nice, Nice, France
Background
Membranous nephropathy (MN) is a rare autoimmune kidney disease and a leading cause of nephrotic syndrome in adults. Anti-CD20 monoclonal antibodies are now recommended as first-line therapy for MN. However, their use can lead to the development of anti-drug antibodies, which may interfere with therapeutic response. In MN, anti-rituximab antibodies have been shown to neutralize the cytotoxic activity of rituximab, thereby increasing the risk of relapse of nephrotic syndrome and reducing remission rates. Obinutuzumab, a humanized anti-CD20 monoclonal antibody, is increasingly used in glomerular diseases, particularly in patients resistant to rituximab. It has been reported to be more effective than rituximab in patients with MN who have developed anti-rituximab antibodies. However, immunization against obinutuzumab and its clinical impact in MN have not yet been studied.
Methods
This retrospective study included 10 patients with MN treated with obinutuzumab at our center. Anti-obinutuzumab antibodies were monitored after treatment initiation using electrochemiluminescence assays.
Results
Eight of ten patients developed anti-obinutuzumab antibodies after a median of 10.5 months. In vitro, these antibodies impaired obinutuzumab-induced B-cell depletion and reduced CD20 binding. Clinically, anti-obinutuzumab antibodies were associated with a trend toward lower B-cell depletion at 12 months. During follow-up, immunized patients showed a higher risk of disease relapse than non-immunized patients.
Conclusion
Immunization against obinutuzumab is frequent and associated with reduced drug efficacy.
Acknowledgment
This work was sponsored by the Centre Hospitalier Universitaire de Nice (University Hospital of Nice) for regulatory and ethic submission.
Evolution of the percentage of CD19+ cells among lymphocytes after in vitro exposure of healthy donor blood to obinutuzumab and to MN patient serum before and after the development of anti-obinutuzumab antibodies.
Funding
- NIDDK Support