Has the MAJESTY trial changed your approach to the rituximab versus obinutuzumab choice in a patient with newly diagnosed primary membranous nephropathy and nephrotic syndrome?

The Bottom Line: Recent landmark trials—MENTOR and MAJESTY—confirm that anti-CD20 therapies are superior to calcineurin inhibitors (CNIs) for the treatment of MN.

Key Trial Data

MENTOR: Demonstrated that RTX was noninferior to cyclosporine at 12 months, and decisively superior by 24 months (60% vs. 20...

I do not think it changes my approach, other than to provide more evidence that anti-CD20 antibodies are more effective than CNIs. There is still no head-to-head comparison of rituximab vs. obinutuzumab. However, the information that is available suggests that obi is more effective than ritux. My li...