title: Rituximab as a rescue therapy in patients with glomerulonephritis.
abstract: To evaluate the use of rituximab in the treatment of severe glomerulonephritis (GN) in order to prevent progression of kidney disease toward the end stage, we designed a multicenter, retrospective study in Saudi Arabia about the efficacy and safety of the use of "off label" rituximab in a variety of severe refractory GN to conventional treatment and the progression of kidney disease for at least one year of follow-up. All the patients had kidney biopsies before treatment with rituximab, and proteinuria and glomerular filtration rate (GFR) were followed-up for the period of the study. The immediate side-effect at the time of administration of rituximab included itching in three patients, hypotension in one patient and anaphylaxis in one patient (dropped out from the study). After the administration of rituximab in 42 patients and during the first six months of therapy, 16 (38%) patients had complete remission (CR), 13 (31%) patients had partial remission (PR) and 13 (31%) patients had no remission. The mean follow-up period for the patients was 19.0 ± 6.97 months (median 18.0 months). The long-term follow-up during the study period disclosed a good hospitalization record for almost all of the patients. Membranous GN (MGN) was the largest group in the cohort (58% of the patients), and we observed CR and PR in 40% and 28% of them, respectively, which was comparable with the previous experience with rituximab in MGN patients with more CR than PR in our cohort. We conclude that our study suggests the safety and efficacy of the use of rituximab in patients with refractory GN and that larger and long-term prospective studies are required to define the role of rituximab in the different categories of these diseases.
authors.affiliation: The Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia.
authors.forename: Muhammad Ziad
authors.initials: MZ
authors.lastname: Souqiyyeh
authors.forename: Faissal A M
authors.initials: FA
authors.lastname: Shaheen
authors.forename: Abdulkareem
authors.initials: A
authors.lastname: Alsuwaida
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alghonaim
authors.forename: Jamal
authors.initials: J
authors.lastname: Alwakeel
authors.forename: Dujana
authors.initials: D
authors.lastname: Mosa
authors.forename: Faheem
authors.initials: F
authors.lastname: Akhtar
authors.forename: Ebadur
authors.initials: E
authors.lastname: Rahman
authors.forename: Maged
authors.initials: M
authors.lastname: Husain
authors.forename: Hysam
authors.initials: H
authors.lastname: Roujouleh
authors.forename: Nauman
authors.initials: N
authors.lastname: Siddiqi
authors.forename: Ibtissam
authors.initials: I
authors.lastname: Bukhari
authors.forename: Nihal
authors.initials: N
authors.lastname: Sadaqa
authors.forename: Faissal
authors.initials: F
authors.lastname: Mushtaque
authors.forename: Neveen Mustafa
authors.initials: NM
authors.lastname: Awn
authors.forename: Fouad
authors.initials: F
authors.lastname: Shariya
authors.forename: Adnan
authors.initials: A
authors.lastname: Alfi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Amin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ahmad
authors.forename: Fadel Abbas
authors.initials: FA
authors.lastname: Rowaie
authors.forename: Samir
authors.initials: S
authors.lastname: Almueilo
authors.forename: Mohamed Chihab Eddine
authors.initials: MC
authors.lastname: Kechrid
authors.forename: Ayman
authors.initials: A
authors.lastname: Karkar
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use; D011507:Proteinuria / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D016879:Salvage Therapy; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D012709:Serum Albumin; D000069283:Rituximab