With the deepening understanding of the pathogenesis of membranous nephropathy (MN), novel targeted drugs, including those targeting B cells, plasma cells, and the complement system, have provided new treatment options for MN, especially for refractory membranous nephropathy (RMN). These novel targeted drugs precisely act on key pathological components such as B cells, plasma cells, and the complement system, demonstrating significant efficacy with minimal adverse effects. This review systematically summarizes the clinical research progress of drugs such as anti-CD20 monoclonal antibodies, anti-B cell activating factor monoclonal antibodies, and anti-CD38 monoclonal antibodies in the treatment of MN and RMN, analyzing the mechanisms by which these novel targeted drugs precisely regulate immune responses to enhance clinical outcomes. It emphasizes the importance of individualized treatment strategies based on the pathogenesis and disease state, explores the potential of combination therapies, and aims to provide new insights for the precise treatment of MN and RMN.

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