Long-term efficacy of anti-CD20 antibodies in refractory lupus nephritis.
Eight patients with refractory lupus nephritis received rituximab after failing standard sequential therapy and were followed for 104 weeks after the infusion. One patient died secondary to a complicated pregnancy but had stable renal function. Three patients received a re-infusion of rituximab approximately 12 months apart due to a renal flare; during the second year of follow-up, those patients progressed toward ESRD. The four remaining patients demonstrated improvements in SLEDAI score, CrCl, and proteinuria with maintenance of their standard immunosuppressive therapy and did not require a re-infusion of rituximab. Although rituximab as induction therapy for refractory lupus nephritis has been shown to have a good response, its efficacy in long-term assessments demonstrates disappointing results.
Division of Internal Medicine, Hospital Central Sur de PEMEX, Mexico city, Mexico. cesararces@yahoo.com
C Alejandro
CA
Arce-Salinas
Felipe
F
Rodríguez-García
J Iván
JI
Gómez-Vargas
D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D018951:Antigens, CD20 / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D004334:Drug Administration Schedule; D004351:Drug Resistance; D057915:Drug Substitution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007676:Kidney Failure, Chronic / Q000209:etiology; D008181:Lupus Nephritis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D000069283:Rituximab; D012720:Severity of Illness Index; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D015415:Biomarkers; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003404:Creatinine
J Rheumatol. 1992 Oct;19(10):1551-8
1464867
Lupus. 2009 Aug;18(9):767-76
19578100
N Engl J Med. 2000 Oct 19;343(16):1156-62
11036121
Arthritis Res Ther. 2006;8(3):R83
16677395
J Am Soc Nephrol. 2004 Feb;15(2):241-50
14747370
Lupus. 2005;14(11):890-5
16335581
Am J Kidney Dis. 2008 Aug;52(2):346-52
18572292
J Rheumatol. 1999 Dec;26(12):2595-601
10606368
Kidney Int. 2000 Jan;57(1):258-64
10620207
Arthritis Rheum. 1982 Nov;25(11):1271-7
7138600
Curr Opin Rheumatol. 2004 May;16(3):180-5
15103242
Autoimmun Rev. 2006 Jan;5(1):18-24
16338207
Lupus. 2010 Feb;19(2):213-9
19965944
J Rheumatol. 2008 May;35(5):826-33
18398943
Arch Intern Med. 2000 Nov 13;160(20):3136-40
11074743
Clin J Am Soc Nephrol. 2006 Jul;1(4):863-8
17699298
Ann Intern Med. 1996 Oct 1;125(7):549-57
8815753
Arthritis Rheum. 2007 Apr;56(4):1263-72
17393458
Ann Rheum Dis. 2003 Sep;62(9):799-804
12922948
J Rheumatol. 2007 Oct;34(10):2024-7
17696272
Nephrol Dial Transplant. 2006 Jun;21(6):1742-3
16431889
Arthritis Rheum. 2005 Feb;52(2):501-13
15693003
J Immunol. 2000 Nov 15;165(10):5970-9
11067960
Rheumatology (Oxford). 2008 Mar;47(3):329-33
18238790
Lupus. 2003;12(10):798-800
14596432
Lupus. 1998;7(9):622-9
9884100