{
  "abstract": "Introduction\n\nB cell depletion with rituximab (RTX) leads to complete or partial remission (CR or PR) in approximately 60% of patients with primary membranous nephropathy (PMN). Adding belimumab (BEL) to RTX may result in greater depletion of memory B cells, limit the reemergence of autoreactive B cells, and improve clinical responses.Methods\n\nREBOOT Part A (NCT03949855) is a single arm, open-label, pharmacokinetic study where all participants had proteinuria (≥ 4 g/d) and detectable serum anti-phospholipase A2 receptor (anti-PLA2R) antibodies. Participants received BEL 200 mg subcutaneously weekly for 52 weeks and RTX 1000 mg intravenously at weeks 4 and 6. Assessments included BEL exposure at week 4 and CR or PR at week 104.Results\n\nA total of 17 participants started BEL. BEL exposure was not significantly reduced in those with high proteinuria (≥8 g/day) at week 4. Among all treated participants, 10/17 (59%) achieved CR or PR at week 104, whereas in per protocol analyses, 10/11 (91%) achieved CR or PR at week 104. All participants in per protocol analyses had normal serum albumin and undetectable serum anti-PLA2R by week 104. Circulating memory B cells increased before RTX and were depleted by RTX. B cell reconstitution occurred after week 52 with primarily naive and transitional B cells. BEL with RTX was well-tolerated, with 1 participant discontinuing BEL due to infection.Conclusion\n\nIn this study, a high proportion of participants receiving BEL with RTX achieved CR or PR. Therefore, a multitargeted approach to B cell depletion may improve immunologic and clinical outcomes in PMN and is being studied in a larger, randomized, placebo-controlled clinical trial.",
  "abstract_shown": true,
  "affiliations": [
    "Immune Tolerance Network, San Francisco, California, USA.",
    "Rho, Durham, North Carolina, USA.",
    "Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA.",
    "Immune Tolerance Network, Ann Arbor, Michigan, USA.",
    "Division of Nephrology, Hypertension, and Transplantation, Department of Internal Medicine, University of California, Los Angeles, Los Angeles, California, USA.",
    "Lundquist Research Institute, Torrance, California, USA.",
    "Division of Nephrology and Hypertension, Mayo Clinic, Jacksonvill, Florida, USA.",
    "Division of Nephrology, Department of Medicine, Ohio State University, Columbus, Ohio, USA.",
    "Division of Nephrology, Department of Medicine, David Koch Jr. Glomerular Kidney Center, Columbia University, New York City, New York, USA.",
    "Renal, Electrolyte, and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.",
    "Division of Nephrology and Hypertension, Department of Medicine, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.",
    "Division of Nephrology, Department of Medicine, Stanford University, Palo Alto, California, USA.",
    "Nephrology Division, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.",
    "Providence Medical Research Center, Providence Inland Northwest Health, Spokane, Washington, USA.",
    "Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.",
    "Kidney Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA.",
    "Division of Nephrology and Hypertension, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
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        0
      ],
      "name": "Sharon A Chung"
    },
    {
      "affs": [
        1
      ],
      "name": "Lia Stelzig"
    },
    {
      "affs": [
        2
      ],
      "name": "Matthew A Sherman"
    },
    {
      "affs": [
        2
      ],
      "name": "Wendy Gao"
    },
    {
      "affs": [
        0
      ],
      "name": "Patricia Tosta"
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    {
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        3
      ],
      "name": "Laura A Cooney"
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    {
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        4,
        5
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      "name": "Sharon Adler"
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    {
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        6
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      "name": "Nabeel Aslam"
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    {
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        7
      ],
      "name": "Isabelle Ayoub"
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    {
      "affs": [
        8
      ],
      "name": "Andrew S Bomback"
    },
    {
      "affs": [
        9
      ],
      "name": "Gaia Coppock"
    },
    {
      "affs": [
        10
      ],
      "name": "Vimal K Derebail"
    },
    {
      "affs": [
        11
      ],
      "name": "Fahmeedah Kamal"
    },
    {
      "affs": [
        12
      ],
      "name": "Dana V Rizk"
    },
    {
      "affs": [
        13,
        14
      ],
      "name": "Katherine R Tuttle"
    },
    {
      "affs": [
        15
      ],
      "name": "Meryl Waldman"
    },
    {
      "affs": [
        1
      ],
      "name": "William T Barry"
    },
    {
      "affs": [
        16
      ],
      "name": "Patrick H Nachman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/48ryh90cwgm1p.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ekir.2026.107075",
  "fulltext_url": "https://europepmc.org/articles/PMC13694963",
  "id": "48ryh90cwgm1p",
  "issns": [
    "2468-0249"
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  "landing_url": "https://europepmc.org/article/MED/42926931",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2727|Renal Diseases and Glomerulopathies"
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  "openalex": "W7204782079",
  "pdf_url": "https://europepmc.org/articles/PMC13694963?pdf=render",
  "pmcid": "PMC13694963",
  "pmid": "42926931",
  "published": "2026-09-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/48ryh90cwgm1p.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42926931",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42926931"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Renal Diseases and Glomerulopathies",
      "subfield": "general"
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  ],
  "title": "Belimumab With Rituximab for the Treatment of Primary Membranous Nephropathy.",
  "title_text": "Belimumab With Rituximab for the Treatment of Primary Membranous Nephropathy.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/48ryh90cwgm1p",
  "venue": "Kidney international reports",
  "versions": [
    {
      "doi": "10.64898/2026.08.26.26360913",
      "pid": "3yrnkveabb888",
      "relation": "preprint",
      "title": "Belimumab with rituximab for the treatment of primary membranous nephropathy",
      "venue": "medRxiv"
    }
  ]
}