Obinutuzumab or Tacrolimus in Primary Membranous Nephropathy.
N Engl J MedJun 5, 2026 (epub)
Clinical ResearchNephrology
Fernando C Fervenza, Fan Fan Hou, Chuan-Ming Hao et al.
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In 30 seconds
This phase 3 randomized controlled trial evaluated the efficacy of obinutuzumab versus tacrolimus in adults with primary membranous nephropathy. Among 142 patients, complete remission was achieved in 37% of the obinutuzumab group compared to 6% in the tacrolimus group (adjusted difference, 31 percentage points; P<0.001) at week 104, indicating a significant treatment effect.
Key findings
- Complete remission at week 104 was 37% in the obinutuzumab group versus 6% in the tacrolimus group.
- The adjusted difference in complete remission rates was 31 percentage points (95% CI, 18 to 44).
- Adverse events of grade 3 or higher occurred in 22% of the obinutuzumab group and 19% of the tacrolimus group.
- Infections were reported at a rate of 61 per 100 patient-years for obinutuzumab and 57 for tacrolimus.
Why it matters
The findings suggest that obinutuzumab may be a more effective treatment option for achieving complete remission in patients with primary membranous nephropathy compared to tacrolimus, which could influence treatment decisions in this patient population.