
The KDIGO 2021 guideline recommends Rituximab (RTX) and cyclophosphamide (CYC) as first-line treatments for idiopathic membranous nephropathy (IMN). A study involving 600 IMN patients found that RTX had a similar overall remission rate as CYC but was associated with a lower complete/partial remission rate. RTX was also less effective in patients with high antiPLA2R antibody levels. However, CRs, relapse rates, immunologic responses, and severe adverse events did not significantly differ from RTX and CYC. While CYC and RTX showed comparable long-term efficacy and safety, CYC offers faster results and is more beneficial for IMN patients with high antiPLA2R antibody levels.
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