Daratumumab plus anti-CD20 rescues refractory recurrent FSGS after transplant

This real-world cohort suggests combined plasma-cell and B-cell depletion can induce remission and free apheresis-dependent patients with recurrent FSGS who have exhausted standard therapy.

daratumumabanti-CD38rituximabobinutuzumabanti-CD20recurrent FSGSfocal segmental glomerulosclerosiskidney transplantationantinephrin antibodyplasma cell depletionretrospective cohortnephrotic syndrome Rheumatology / Immunology

Background Information

Can dual antibody therapy offer a lifeline for transplant patients with recurrent FSGS?

Recurrent focal segmental glomerulosclerosis (rFSGS) after kidney transplantation is difficult to treat, and effective therapies are needed. In a study of 17 patients, 41% achieved complete remission and 24% achieved partial remission with combined anti-CD38 and anti-CD20 therapy. The combination therapy showed promising remission rates and reduced proteinuria in rFSGS, highlighting potential for wider clinical use pending further trials. Combined anti-CD38 and anti-CD20 therapy may offer new hope for managing refractory rFSGS post-kidney transplant.

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Authors: Leon J, Ducrocq E, Lafargue MC, Bertrand D, Maigret L, Zaidan M, Colin AM, Thervet E, Durrbach A, Kamar N, Schvartz B, Bouvier N, Mazloum M, Bennani HN, Guezennec M, Es-Saleh D, Troger A, Burger C, Le Stang MB, Roger C, Hullekes F, Aubert O, Zuber J, Riella LV, Audard V, Anglicheau D

Citation: Leon J, Ducrocq E, Lafargue MC, et al. Anti-CD38/Anti-CD20 Rescue Therapy for Posttransplant Recurrent FSGS. Kidney international reports. 2026;11(9):106668. doi:10.1016/j.ekir.2026.106668

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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