Complete remission of lupus nephritis with rituximab and steroids for induction and rituximab alone for maintenance therapy.
Lupus nephritis (LN) is a severe and frequent complication of systemic lupus erythematosus. For decades, cyclophosphamide-based regimens have been the gold standard in treating patients with LN. However, cyclophosphamide use is associated with increased morbidity and mortality, and thus alternative treatments are needed. We report 3 cases of severe class IV LN successfully treated with rituximab as an induction, as well as a long-term maintenance, treatment. Complete remission of LN, documented by means of a control kidney biopsy, occurred in all patients and was maintained during follow-up using rituximab as sole maintenance treatment. No severe infectious complications were observed during treatment with rituximab. Our data suggest that rituximab may prove to be an optimal maintenance treatment in patients with severe LN.
Department of Nephrology, Université Paris V-René Descartes, APHP, Hôpital Necker-Enfants Malades, Paris, France.
Laurent
L
Camous
Catherine
C
Melander
Marion
M
Vallet
Tarek
T
Squalli
Bertrand
B
Knebelmann
Laure-Hélène
LH
Noël
Fadi
F
Fakhouri
D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001706:Biopsy; D049109:Cell Proliferation; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007668:Kidney / Q000473:pathology; D008181:Lupus Nephritis / Q000188:drug therapy* / Q000473:pathology; D008856:Microscopy, Fluorescence; D012074:Remission Induction; D000069283:Rituximab; D012720:Severity of Illness Index; D013997:Time Factors
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D005938:Glucocorticoids; D007155:Immunologic Factors; D000069283:Rituximab