Table 2.

Strengths and limitations of rituximab in membranous nephropathy

	Pro	Con
Efficacy	Remission in two-thirds of treated patients	Possibly lower CR rates compared with a cyclical therapy
	Low relapse rates
Application	Simple dosing	Frequent IRR
	Long intervals (≥6 mo) and in PLA2R Ab-positive patients serologic monitoring option for maintenance treatment	Delicate scheduling due to persistent B-cell depletion (e.g., during COVID-19 pandemic)
Side effects	Overall beneficial safety profile; low rates of SAE	No long-term experience, late-onset neutropenia
Long-term sequelae	No increased malignancy risk, no increase in cardiovascular mortality	Treatment-associated long-lasting hypogammaglobulinemia

COVID-19, coronavirus disease 2019; CR, complete remission; IRR; infusion-related reactions; PLA2R Ab, M-type phospholipase A2 receptor antibody; SAE, severe adverse events.