Ines Mahmoud1, Manel Jellouli2, Imen Boukhris3, Rim Charfi4, Aicha Ben Tekaya5, Olfa Saidane5, Maryem Ferjani2, Yousra Hammi2, Sameh Trabelsi4, Narjess Khalfallah3, Rawdha Tekaya5, Tahar Gargah2, Leila Abdelmoula5. 1. Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia. Electronic address: nefmhd@yahoo.fr. 2. Department of Pediatric Nephrology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia. 3. Department of Internal Medicine, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia. 4. Department of Clinical Pharmacology, National Centre of Pharmacovigilance, Faculty of Medicine, Manar University, Tunis, Tunisia. 5. Department of Rheumatology, Charles Nicolle Hospital, Faculty of Medicine, Manar University, Tunis, Tunisia.
Abstract
OBJECTIVES: To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE). STUDY DESIGN: We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions. Study eligibility criteria included clinical trials and observational studies with a minimal sample size of 5 patients, regarding treatment with rituximab in patients with refractory pSLE (aged <18 years at the time of diagnosis). Independent extraction of articles was performed by 2 investigators using predefined data fields. RESULTS: Twelve case series met the criteria for data extraction for the systematic review with a good quality assessment according to an 18-criteria checklist using a modified Delphi method. Among them, 3 studies were multicenter and 3 were prospective. The total number of patients was 272. Studies collected patients with active disease refractory to steroids and immunosuppressant drugs. Refractory lupus nephritis was the most common indication (33%). Acceptable evidence suggested improvements in renal, neuropsychiatric and haematological manifestations, disease activity, complement and anti-double stranded Desoxy-Nucleo-Adenosine, with a steroid-sparing effect. However, there was poor evidence suggesting efficacy on arthralgia, photosensitivity, and mucocutaneous manifestations of SLE in children. An overall acceptable safety profile with few major adverse events was shown. CONCLUSION: Rituximab exhibited a satisfactory profile regarding efficacy and safety indicating that this agent is a promising therapy for pSLE and should be further investigated.
OBJECTIVES: To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE). STUDY DESIGN: We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions. Study eligibility criteria included clinical trials and observational studies with a minimal sample size of 5 patients, regarding treatment with rituximab in patients with refractory pSLE (aged <18 years at the time of diagnosis). Independent extraction of articles was performed by 2 investigators using predefined data fields. RESULTS: Twelve case series met the criteria for data extraction for the systematic review with a good quality assessment according to an 18-criteria checklist using a modified Delphi method. Among them, 3 studies were multicenter and 3 were prospective. The total number of patients was 272. Studies collected patients with active disease refractory to steroids and immunosuppressant drugs. Refractory lupus nephritis was the most common indication (33%). Acceptable evidence suggested improvements in renal, neuropsychiatric and haematological manifestations, disease activity, complement and anti-double stranded Desoxy-Nucleo-Adenosine, with a steroid-sparing effect. However, there was poor evidence suggesting efficacy on arthralgia, photosensitivity, and mucocutaneous manifestations of SLE in children. An overall acceptable safety profile with few major adverse events was shown. CONCLUSION:Rituximab exhibited a satisfactory profile regarding efficacy and safety indicating that this agent is a promising therapy for pSLE and should be further investigated.
Authors: Surabhi S Vinod; Annelle B Reed; Jamelle Maxwell; Randy Q Cron; Matthew L Stoll Journal: Pediatr Rheumatol Online J Date: 2018-03-09 Impact factor: 3.054
Authors: Casey Lee McAtee; Joseph Lubega; Kristen Underbrink; Kristen Curry; Pavlos Msaouel; Martha Barrow; Eyal Muscal; Timothy Lotze; Poyyapakkam Srivaths; Lisa R Forbes; Carl Allen; M Brooke Bernhardt Journal: JAMA Netw Open Date: 2021-02-01
Authors: Tim D Cheetham; Michael Cole; Mario Abinun; Amit Allahabadia; Tim Barratt; Justin H Davies; Paul Dimitri; Amanda Drake; Zainaba Mohamed; Robert D Murray; Caroline A Steele; Nicola Zammitt; Sonya Carnell; Jonathan Prichard; Gillian Watson; Sophie Hambleton; John N S Matthews; Simon H S Pearce Journal: J Clin Endocrinol Metab Date: 2022-02-17 Impact factor: 5.958