REmission in Membranous Nephropathy International Trial (REMIT)

"Participants will receive an intravenous infusion of 1,000mg Obinutuzumab at Weeks 0, 2, 24 and 26.~Prior to the administration of obinutuzumab, the participant will receive pre-medications consisting of all three:~* IV methylprednisolone 80 mg,~* Paracetamol 1,000 mg orally,~* Either cetirizine 10 mg orally or diphenhydramine 50 mg orally. These pre-medications must be completed between 30 to 60 minutes prior to the obinutuzumab infusion."

"Participants will receive a combination of oral prednisolone and cyclophosphamide with 2 options (Option A and B).~Option A: Cyclical prednisolone and cyclophosphamide with IV methylprednisolone~* IV methylprednisolone 500-1000 mg will be given on days 1, 2 and 3 at the start of months 1, 3, and 5.~* Oral prednisolone will be given at 0.5 mg/kg/day (max 50 mg/day) in months 1, 3, and 5.~* Oral cyclophosphamide will be given in months 2, 4 and 6, adjusted by age and weight~Option B: Concurrent prednisolone and cyclophosphamide without IV methylprednisolone~* Oral prednisolone will be given to meet a cumulative dose equivalent to 0.5 mg/kg/day for 90 days (max 50 mg/day).~* Oral cyclophosphamide will be given for 90 days, adjusted by age and weight"