Zhi-Ying Li1,2,3,4, Min Chen1,2,3,4, Ming-Hui Zhao1,2,3,4,5. 1. Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China. 2. Peking University Institute of Nephrology, Beijing, China. 3. Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China. 4. Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China. 5. Peking-Tsinghua Center for Life Sciences, Beijing, China.
Abstract
INTRODUCTION: Severe infections were not rare in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients treated with rituximab. The current study aimed to evaluate severe infections in AAV patients received rituximab administration in a single Chinese center. METHODS: Twenty-seven patients were retrospectively included in this study. Their demographic and clinical data were analyzed. Severe infections were classified as grade ≥3 as proposed by the Common Terminology Criteria for Adverse Events V.4.0. RESULTS: Patients were followed up for 23.6 ± 14.0 months from the time of rituximab initiation (mean rituximab dose 1,270.4 mg). Ten severe infection events were recorded in 10 (37.0%) patients, corresponding to an event rate of 20.9 per 100 person-years. Pulmonary infections were the leading infectious complications (90%). Eight of the 10 infections occurred during the first 12 months of follow-up. In multivariable analysis, severe infection in the first year was independently associated with age (HR: 1.121, 95% CI: 1.011-1.243, p = 0.031) and serum creatinine level (increased by per 88.4 μmol/L; HR: 1.493, 95% CI: 1.017-2.191, p = 0.041). CONCLUSION: In AAV patients receiving ri-tuximab, severe infections were common even with the low-dose regimen. Pulmonary infections were the leading cause, and most infections occurred during the first 12 months of follow-up. Older age and renal dysfunction were the risk factors for infection.
INTRODUCTION: Severe infections were not rare in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients treated with rituximab. The current study aimed to evaluate severe infections in AAV patients received rituximab administration in a single Chinese center. METHODS: Twenty-seven patients were retrospectively included in this study. Their demographic and clinical data were analyzed. Severe infections were classified as grade ≥3 as proposed by the Common Terminology Criteria for Adverse Events V.4.0. RESULTS: Patients were followed up for 23.6 ± 14.0 months from the time of rituximab initiation (mean rituximab dose 1,270.4 mg). Ten severe infection events were recorded in 10 (37.0%) patients, corresponding to an event rate of 20.9 per 100 person-years. Pulmonary infections were the leading infectious complications (90%). Eight of the 10 infections occurred during the first 12 months of follow-up. In multivariable analysis, severe infection in the first year was independently associated with age (HR: 1.121, 95% CI: 1.011-1.243, p = 0.031) and serum creatinine level (increased by per 88.4 μmol/L; HR: 1.493, 95% CI: 1.017-2.191, p = 0.041). CONCLUSION: In AAV patients receiving ri-tuximab, severe infections were common even with the low-dose regimen. Pulmonary infections were the leading cause, and most infections occurred during the first 12 months of follow-up. Older age and renal dysfunction were the risk factors for infection.
Authors: Loïc Guillevin; Christian Pagnoux; Alexandre Karras; Chahera Khouatra; Olivier Aumaître; Pascal Cohen; François Maurier; Olivier Decaux; Jacques Ninet; Pierre Gobert; Thomas Quémeneur; Claire Blanchard-Delaunay; Pascal Godmer; Xavier Puéchal; Pierre-Louis Carron; Pierre-Yves Hatron; Nicolas Limal; Mohamed Hamidou; Maize Ducret; Eric Daugas; Thomas Papo; Bernard Bonnotte; Alfred Mahr; Philippe Ravaud; Luc Mouthon Journal: N Engl J Med Date: 2014-11-06 Impact factor: 91.245
Authors: Mark A Little; Peter Nightingale; C A Verburgh; Thomas Hauser; Kirsten De Groot; Caroline Savage; David Jayne; Lorraine Harper Journal: Ann Rheum Dis Date: 2009-07-01 Impact factor: 19.103
Authors: C Mukhtyar; O Flossmann; B Hellmich; P Bacon; M Cid; J W Cohen-Tervaert; W L Gross; L Guillevin; D Jayne; A Mahr; P A Merkel; H Raspe; D Scott; J Witter; H Yazici; R A Luqmani Journal: Ann Rheum Dis Date: 2007-10-02 Impact factor: 19.103
Authors: Alexandra Serris; Zahir Amoura; Florence Canouï-Poitrine; Benjamin Terrier; Eric Hachulla; Nathalie Costedoat-Chalumeau; Thomas Papo; Olivier Lambotte; David Saadoun; Miguel Hié; Philippe Blanche; Bertrand Lioger; Jacques-Eric Gottenberg; Bertrand Godeau; Marc Michel Journal: Am J Hematol Date: 2018-01-25 Impact factor: 10.047
Authors: Pierre Charles; Benjamin Terrier; Élodie Perrodeau; Pascal Cohen; Stanislas Faguer; Antoine Huart; Mohamed Hamidou; Christian Agard; Bernard Bonnotte; Maxime Samson; Alexandre Karras; Noémie Jourde-Chiche; François Lifermann; Pierre Gobert; Catherine Hanrotel-Saliou; Pascal Godmer; Nicolas Martin-Silva; Grégory Pugnet; Marie Matignon; Olivier Aumaitre; Jean-François Viallard; François Maurier; Nadine Meaux-Ruault; Sophie Rivière; Jean Sibilia; Xavier Puéchal; Philippe Ravaud; Luc Mouthon; Loïc Guillevin Journal: Ann Rheum Dis Date: 2018-04-25 Impact factor: 19.103
Authors: Andreas Kronbichler; Julia Kerschbaum; Seerapani Gopaluni; Joanna Tieu; Federico Alberici; Rachel Bronwen Jones; Rona M Smith; David R W Jayne Journal: Ann Rheum Dis Date: 2018-06-27 Impact factor: 19.103
Authors: Balazs Odler; Martin Windpessl; Marcell Krall; Maria Steiner; Regina Riedl; Carina Hebesberger; Martin Ursli; Emanuel Zitt; Karl Lhotta; Marlies Antlanger; Daniel Cejka; Philipp Gauckler; Martin Wiesholzer; Marcus Saemann; Alexander R Rosenkranz; Kathrin Eller; Andreas Kronbichler Journal: Front Immunol Date: 2021-10-29 Impact factor: 7.561