BACKGROUND AND OBJECTIVES: Standard treatment for lupus nephritis, including corticosteroids and cyclophosphamide, is efficient but is still associated with refractory or relapsing disease, or severe deleterious effects. Rituximab, a monoclonal chimeric anti-B cell antibody, is increasingly used in patients with lupus nephritis, but reported series were small and had a short follow-up. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The authors analyzed clinical and histologic data of 20 patients who were treated with rituximab for lupus nephritis and followed up for at least 12 mo. RESULTS: Nineteen women and one man received rituximab as induction treatment for an active class IV (15 cases) or class V (5 cases) lupus nephritis. Rituximab was given for lupus nephritis refractory to standard treatment (12 cases), for relapsing disease (6 cases), or as first-line treatment (2 cases). Three patients received cyclophosphamide concomitantly with rituximab. Ten received new injections of rituximab as maintenance therapy. Side effects included mainly five infections and four moderate neutropenias. After a median follow-up of 22 mo, complete or partial renal remission was obtained in 12 patients (60%). Lupus nephritis relapsed in one patient, who responded to a new course of rituximab. The achievement of B cell depletion 1 mo after rituximab, which negatively correlated with black ethnicity and hypoalbuminemia, was strongly associated with renal response. Rapidly progressive glomerulonephritis did not respond to rituximab. CONCLUSION: Rituximab is an interesting therapeutic option in relapsing or refractory lupus nephritis when early B cell depletion is obtained.
BACKGROUND AND OBJECTIVES: Standard treatment for lupus nephritis, including corticosteroids and cyclophosphamide, is efficient but is still associated with refractory or relapsing disease, or severe deleterious effects. Rituximab, a monoclonal chimeric anti-B cell antibody, is increasingly used in patients with lupus nephritis, but reported series were small and had a short follow-up. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The authors analyzed clinical and histologic data of 20 patients who were treated with rituximab for lupus nephritis and followed up for at least 12 mo. RESULTS: Nineteen women and one man received rituximab as induction treatment for an active class IV (15 cases) or class V (5 cases) lupus nephritis. Rituximab was given for lupus nephritis refractory to standard treatment (12 cases), for relapsing disease (6 cases), or as first-line treatment (2 cases). Three patients received cyclophosphamide concomitantly with rituximab. Ten received new injections of rituximab as maintenance therapy. Side effects included mainly five infections and four moderate neutropenias. After a median follow-up of 22 mo, complete or partial renal remission was obtained in 12 patients (60%). Lupus nephritis relapsed in one patient, who responded to a new course of rituximab. The achievement of B cell depletion 1 mo after rituximab, which negatively correlated with black ethnicity and hypoalbuminemia, was strongly associated with renal response. Rapidly progressive glomerulonephritis did not respond to rituximab. CONCLUSION:Rituximab is an interesting therapeutic option in relapsing or refractory lupus nephritis when early B cell depletion is obtained.
Authors: D G Maloney; A J Grillo-López; C A White; D Bodkin; R J Schilder; J A Neidhart; N Janakiraman; K A Foon; T M Liles; B K Dallaire; K Wey; I Royston; T Davis; R Levy Journal: Blood Date: 1997-09-15 Impact factor: 22.113
Authors: G G Illei; H A Austin; M Crane; L Collins; M F Gourley; C H Yarboro; E M Vaughan; T Kuroiwa; C L Danning; A D Steinberg; J H Klippel; J E Balow; D T Boumpas Journal: Ann Intern Med Date: 2001-08-21 Impact factor: 25.391
Authors: R John Looney; Jennifer H Anolik; Debbie Campbell; Raymond E Felgar; Faith Young; Lois J Arend; James A Sloand; Joseph Rosenblatt; Iñaki Sanz Journal: Arthritis Rheum Date: 2004-08
Authors: Jennifer H Anolik; Debbie Campbell; Raymond E Felgar; Faith Young; Inaki Sanz; Joseph Rosenblatt; R John Looney Journal: Arthritis Rheum Date: 2003-02
Authors: Jan J Weening; Vivette D D'Agati; Melvin M Schwartz; Surya V Seshan; Charles E Alpers; Gerald B Appel; James E Balow; Jan A Bruijn; Terence Cook; Franco Ferrario; Agnes B Fogo; Ellen M Ginzler; Lee Hebert; Gary Hill; Prue Hill; J Charles Jennette; Norella C Kong; Philippe Lesavre; Michael Lockshin; Lai-Meng Looi; Hirofumi Makino; Luiz A Moura; Michio Nagata Journal: Kidney Int Date: 2004-02 Impact factor: 10.612
Authors: I Danés; A Agustí; A Vallano; J Martínez; C Alerany; A Ferrer; A López; J Cortés-Hernández; J A Bosch Journal: Eur J Clin Pharmacol Date: 2013-05-23 Impact factor: 2.953