Abstract: TH-PO1264
Maintenance Rituximab Reduces Relapse in Phospholipase A2 Receptor (PLA2R)-Related Membranous Nephropathy: A Retrospective Cohort Study
Session Information
- Late-Breaking Research Posters
October 22, 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
- Xie, Jingyuan, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Hu, Xiaofan, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Background
To investigate the role of maintenance rituximab in reducing relapses in primary membranous nephropathy (PMN) treated with rituximab.
Methods
This retrospective study enrolled patients with PLA2R-related primary membranous nephropathy who achieved both clinical and immunological remission within 12 months of rituximab treatment. Patients were subsequently stratified into two groups based on whether they received rituximab maintenance therapy at 12 months. Relapse patterns were then compared between 2 groups. Cox regression models and Kaplan–Meier curves were employed to identify independent risk factors for relapse.
Results
A total of 121 PLA2R-related PMN patients who achieved stable remission following rituximab treatment were included. During a median follow up of 36(22-44)m, 35.54% of patients experienced clinical nephrotic relapse. Compared with non-relapsers, relapsers had significantly lower serum albumin both at induction (20 [IQR: 17.5–23] vs. 23 [IQR: 19–26] g/L, P=0.04) and at 12 months (40 [IQR: 37.5–42] vs. 42 [IQR: 39–44] g/L, P=0.03), higher 12-month proteinuria (0.48 [IQR: 0.24–1.12] vs. 0.35 [IQR: 0.19–0.49] g/24h, P=0.03), a lower rate of complete remission (46.5% vs. 83.3%, P<0.01), and less maintenance rituximab use (16.3% vs. 44.9%, P<0.01). Multivariable Cox regression identified complete remission (HR: 0.44, 95% CI 0.22–0.88, P=0.02) and maintenance rituximab (HR 0.24, 95% CI 0.10–0.56, P < 0.01) as independent protective factors against relapse. Patients were then stratified into two groups according to maintenance rituximab therapy. Patients with maintenance rituximab experienced relapses later and had a lower cumulative incidence of relapse ( maintenance rituximab vs. no maintenance rituximab:16.67% vs. 45.57%, P<0.01) . In the subset of patients who had achieved complete remission by 12 months, maintenance rituximab was also associated with a trend toward a reduced relapse risk (HR 0.16, 95% CI 0.02–1.24, P = 0.08). In terms of safety, maintenance rituximab was well tolerated, with no serious adverse events reported.
Conclusion
Complete remission and maintenance rituximab were independently associated with relapse in PLA2R-related PMN patients treated with rituximab. Pursuing for complete remission and reeiving maintenance rituximab may help maintain remission and reduce relapse in PLA2R-related PMN, which required further validation in future RCTs.
Funding
- Clinical Revenue Support