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Sahar Semnani and Eugene Lin

The last two years have brought several promising trials with novel therapies for the treatment of membranous nephropathy, the most common etiology of nephrotic syndrome in adults (1, 2).

Currently, the mainstay of treatment is steroids in combination with alkylating agents (modified Ponticelli regimen) or calcineurin inhibitors (3). With the identification of auto-antibodies against the phospholipase-2 receptor (PLA2R) comes the potential for new therapies (4, 5), including monoclonal antibodies against CD20 on B-lymphocytes: rituximab and obinutuzumab (4).

In 2019, the MENTOR randomized controlled trial showed that rituximab was