Anti-CD20 monoclonal antibodies in membranous nephropathy

Novel anti-CD20 monoclonal antibodies have been developed to optimize B-cell depletion. A key mechanism of action of these therapeutic monoclonal antibodies is the activation of immune cells via Fc receptors (FcγR). B-cell depletion with anti-CD20 monoclonal antibodies was initially developed for the treatment of B-cell lymphoma. Subsequently, its use was extended to autoimmune diseases. Rituximab has long been the main monoclonal antibody used to treat immune-mediated glomerulopathies. In glomerular diseases, rituximab was initially used to treat membranous nephropathy, demonstrating a better safety profile compared to conventional immunosuppressive therapies and a good treatment response. Therefore, other drugs targeting the same therapeutic receptor, anti-CD20, have been developed. This review aims to highlight, from a comprehensive perspective, the different anti-CD20 agents available to date.