The study compared two treatment approaches for primary membranous nephropathy: B-cell-guided rituximab combined with low-dose tacrolimus (57 patients) versus standard rituximab monotherapy (38 patients).[1] In the observation group, the overall remission rate was 71.93% (complete remission 31.58%, partial 40.35%), while in the standard group it was 68.42% (complete 26.32%, partial 42.1%), and the difference was not statistically significant.[1] The combination regimen required a significantly lower total dose of rituximab (0.3 ± 0.16 g versus 2 g) and reduced treatment costs by approximately CNY 20,391 per patient.[1] No serious adverse events occurred in the observation group, while four serious adverse events were reported in the standard group.[1] Analysis identified that non-use of renin-angiotensin system inhibitors was an independent risk factor for non-remission, while higher baseline albumin levels were a protective factor.[1] The study concluded that B-cell-directed rituximab combined with low-dose tacrolimus effectively induces clinical remission with better safety and cost-effectiveness.[1]