Is obinutuzumab an option for FSGS patients who did not respond to rituximab?
For FSGS patients who do not respond to rituximab, obinutuzumab is emerging as a potential treatment option. Obinutuzumab is a newer anti-CD20 antibody that may achieve deeper and more sustained B-cell depletion than rituximab 267. While evidence is still limited to case reports and small studies, results so far are encouraging.
What the research says
A case report described a 33-year-old woman with primary FSGS who achieved only partial remission with corticosteroids and cyclosporine, and no complete remission after rituximab. She then received obinutuzumab (1 g × 2 doses) and achieved complete remission within two months, with sustained B-cell depletion and no adverse events 27. A retrospective case series of 11 adult MCD or FSGS patients who had inadequate response to rituximab found that after obinutuzumab, the first relapse-free time was about 12 months, and six patients (54.5%) stopped corticosteroids and other immunosuppressants within three months 6. In that study, two FSGS patients relapsed, but the rest maintained remission during follow-up 6. These findings suggest obinutuzumab may be effective for some FSGS patients after rituximab failure, but larger studies are needed to confirm safety and efficacy.
What to ask your doctor
- Could obinutuzumab be an option for me given my history of not responding to rituximab?
- What are the potential side effects of obinutuzumab compared to rituximab?
- How is obinutuzumab administered and how many doses would I need?
- Are there any ongoing clinical trials for obinutuzumab in FSGS that I might be eligible for?
- What other treatment options are available if obinutuzumab does not work for me?
This question is drawn from common patient questions about Gastroenterology and answered using cited medical research. We do not provide individualized advice.