The indications, efficacy and adverse events of rituximab in a large cohort of patients with juvenile-onset SLE

Background B cells drive antibody formation and T cell activation. This study aimed to describe the clinical indications, efficacy and adverse events (AEs) for the B-cell depleting agent, rituximab, in a large cohort of children with lupus. Methods Prescribing records and the UK JSLE Cohort Study da...

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Bibliographic Details
Published in:Lupus 2015-01, Vol.24 (1), p.10-17
Main Authors: Watson, L, Beresford, M W, Maynes, C, Pilkington, C, Marks, S D, Glackin, Y, Tullus, K
Format: Article
Language:English
Subjects:
Adolescent
Adrenal Cortex Hormones - therapeutic use
Albuminuria - urine
Antibodies
Antibodies, Antinuclear - blood
Antibodies, Monoclonal, Murine-Derived - adverse effects
Antibodies, Monoclonal, Murine-Derived - therapeutic use
B-Lymphocytes
Biomarkers
Biomarkers - blood
Biomarkers - urine
Blood Sedimentation
Child
Cohort analysis
Complement C3 - metabolism
Complement C4 - metabolism
Creatinine
Creatinine - blood
Creatinine - urine
Disease
DNA - immunology
Drug dosages
Female
Hemoglobin
Hemoglobins - metabolism
Hospitals
Humans
Immunoglobulins - blood
Immunologic Factors - adverse effects
Immunologic Factors - therapeutic use
Lupus
Lupus Erythematosus, Systemic - blood
Lupus Erythematosus, Systemic - drug therapy
Lymphocyte Count
Male
Nephrology
Pediatrics
Retrospective Studies
Rheumatology
Rituximab
Serum Albumin - metabolism
Steroids
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Summary:Background B cells drive antibody formation and T cell activation. This study aimed to describe the clinical indications, efficacy and adverse events (AEs) for the B-cell depleting agent, rituximab, in a large cohort of children with lupus. Methods Prescribing records and the UK JSLE Cohort Study database identified rituximab use. Results Sixty-three patients received 104 courses of intravenous rituximab over a 10-year period. Patients were aged 12.2 (IQR 9.0–13.9) years at diagnosis and 50 (79%) were female. They had disease for 1.4 (0.2–3.0) years at the time of rituximab. Lupus nephritis was the most common indication (36% of first courses). Clinical biomarkers, 2.5 (1.6–4.3) months after treatment, demonstrated a statistically significant improvement in ESR, C3, C4, creatinine, albumin, haemoglobin, anti-dsDNA titres and urine albumin:creatinine ratio. IgG, IgA and IgM levels decreased (p 
ISSN:0961-2033
1477-0962
DOI:10.1177/0961203314547793