BACKGROUND: The monoclonal anti-B cell antibody rituximab (Rituxin, Mabthera) may be of benefit in antibody-driven diseases, including systemic lupus erythematosus (SLE) nephritis. PATIENTS AND TREATMENT: Two female patients with biopsy-confirmed severe and active SLE nephritis despite treatment with cyclophosphamide (CyX) were given four rituximab infusions plus two additional CyX infusions. RESULTS: Both patients tolerated the treatment well and SLE activity improved. On repeat kidney biopsy after the combined treatment, Patient 1 showed a profound reduction of nephritis activity, and she was maintained on low-dose prednisolone only. A repeat biopsy after 1 year confirmed the sustained reduction of lupus nephritis activity. In Patient 2, rebiopsy after combined treatment also showed a significant reduction in disease activity. CONCLUSION: These cases provide histopathological documentation of a significant treatment benefit from rituximab plus CyX in two patients refractory to CyX alone. This combination is being explored further as salvage therapy for such CyX-resistant patients.
BACKGROUND: The monoclonal anti-B cell antibody rituximab (Rituxin, Mabthera) may be of benefit in antibody-driven diseases, including systemic lupus erythematosus (SLE) nephritis. PATIENTS AND TREATMENT: Two female patients with biopsy-confirmed severe and active SLE nephritis despite treatment with cyclophosphamide (CyX) were given four rituximab infusions plus two additional CyX infusions. RESULTS: Both patients tolerated the treatment well and SLE activity improved. On repeat kidney biopsy after the combined treatment, Patient 1 showed a profound reduction of nephritis activity, and she was maintained on low-dose prednisolone only. A repeat biopsy after 1 year confirmed the sustained reduction of lupus nephritis activity. In Patient 2, rebiopsy after combined treatment also showed a significant reduction in disease activity. CONCLUSION: These cases provide histopathological documentation of a significant treatment benefit from rituximab plus CyX in two patients refractory to CyX alone. This combination is being explored further as salvage therapy for such CyX-resistant patients.
Authors: Anthony Chang; Scott G Henderson; Daniel Brandt; Ni Liu; Riteesha Guttikonda; Christine Hsieh; Natasha Kaverina; Tammy O Utset; Shane M Meehan; Richard J Quigg; Eric Meffre; Marcus R Clark Journal: J Immunol Date: 2010-12-27 Impact factor: 5.422
Authors: Andrew J Kinloch; Matthew D Cascino; Jian Dai; Rene S Bermea; Kichul Ko; Margaret Vesselits; Leonard L Dragone; Nirit Mor Vaknin; Maureen Legendre; David M Markovitz; Michael K Okoreeh; Michael J Townsend; Marcus R Clark Journal: Lupus Date: 2020-03-26 Impact factor: 2.911
Authors: Joan T Merrill; C Michael Neuwelt; Daniel J Wallace; Joseph C Shanahan; Kevin M Latinis; James C Oates; Tammy O Utset; Caroline Gordon; David A Isenberg; Hsin-Ju Hsieh; David Zhang; Paul G Brunetta Journal: Arthritis Rheum Date: 2010-01