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Use of Rituximab in Systemic Lupus Erythematosus: A Single Center Experience Over 14 Years
Objective To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or whose disease is refractory to standard immunosuppressive therapy, treated at a single center. Methods This was a retrospective analysis of...
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| Published in: | Arthritis care & research (2010) 2017-02, Vol.69 (2), p.257-262 |
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| container_title | Arthritis care & research (2010) |
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| creator | Aguiar, R. Araújo, C. Martins‐Coelho, G. Isenberg, D. |
| description | Objective
To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or whose disease is refractory to standard immunosuppressive therapy, treated at a single center.
Methods
This was a retrospective analysis of all patients with SLE treated with RTX at 1 center between June 2000 and December 2013. The clinical outcome was assessed by determining British Isles Lupus Assessment Group (BILAG) scores and anti–double‐stranded DNA (anti‐dsDNA) and C3 levels before and 6 months after RTX treatment. For safety analysis, adverse events and deaths were recorded.
Results
Of a total of 115 patients, 93.9% were female, the mean ± SD age at diagnosis was 26.39 ± 11.90 years, and the mean ± SD disease duration at first RTX treatment was 91.96 ± 84.80 months. A BILAG score variation of −11.26 ± 11.38 (P |
| doi_str_mv | 10.1002/acr.22921 |
| format | article |
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To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or whose disease is refractory to standard immunosuppressive therapy, treated at a single center.
Methods
This was a retrospective analysis of all patients with SLE treated with RTX at 1 center between June 2000 and December 2013. The clinical outcome was assessed by determining British Isles Lupus Assessment Group (BILAG) scores and anti–double‐stranded DNA (anti‐dsDNA) and C3 levels before and 6 months after RTX treatment. For safety analysis, adverse events and deaths were recorded.
Results
Of a total of 115 patients, 93.9% were female, the mean ± SD age at diagnosis was 26.39 ± 11.90 years, and the mean ± SD disease duration at first RTX treatment was 91.96 ± 84.80 months. A BILAG score variation of −11.26 ± 11.38 (P < 0.001) was recorded 6 months after the first RTX treatment; 40% of patients had a complete response and 27% had a partial response; in 36.5% of patients, C3 levels increased more than 25%, and in 33.5% anti‐dsDNA levels decreased more than 50%. Depletion of CD19+ cells was achieved in 94.0% of patients. Hypogammaglobulinemia was detected in 14.9% of patients, with significant reduction for IgM (P < 0.001) and IgG (P = 0.001) levels. Severe infections, infusion‐related reactions, and hypersensitivity reactions occurred in 7%, 3.5%, and 2.6% of patients, respectively. Of the 115 patients, 62 patients had repeated RTX treatments, with an average number of 1.95 ± 1.17 cycles per patient and a mean ± SD interval between infusions of 21.44 ± 20.11 months. At the end of followup, 11 patients were deceased; 6 had cardiovascular events.
Conclusion
RTX treatment was effective in decreasing disease activity, with a low incidence of adverse effects.</description><identifier>ISSN: 2151-464X</identifier><identifier>EISSN: 2151-4658</identifier><identifier>DOI: 10.1002/acr.22921</identifier><identifier>PMID: 27110698</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Anti-DNA antibodies ; CD19 antigen ; Female ; Humans ; Hypersensitivity ; Hypogammaglobulinemia ; Immunoglobulin G ; Immunoglobulin M ; Immunologic Factors - therapeutic use ; Immunosuppressive agents ; Immunotherapy ; Lupus ; Lupus Erythematosus, Systemic - drug therapy ; Male ; Middle Aged ; Monoclonal antibodies ; Retrospective Studies ; Rituximab ; Rituximab - therapeutic use ; Side effects ; Systemic lupus erythematosus</subject><ispartof>Arthritis care & research (2010), 2017-02, Vol.69 (2), p.257-262</ispartof><rights>2016, American College of Rheumatology</rights><rights>2016, American College of Rheumatology.</rights><rights>2017, American College of Rheumatology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4211-f26dc3467af276570a4aa523ef3093c286b813614db8ef9365fbaf0547d359453</citedby><cites>FETCH-LOGICAL-c4211-f26dc3467af276570a4aa523ef3093c286b813614db8ef9365fbaf0547d359453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27110698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aguiar, R.</creatorcontrib><creatorcontrib>Araújo, C.</creatorcontrib><creatorcontrib>Martins‐Coelho, G.</creatorcontrib><creatorcontrib>Isenberg, D.</creatorcontrib><title>Use of Rituximab in Systemic Lupus Erythematosus: A Single Center Experience Over 14 Years</title><title>Arthritis care & research (2010)</title><addtitle>Arthritis Care Res (Hoboken)</addtitle><description>Objective
To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or whose disease is refractory to standard immunosuppressive therapy, treated at a single center.
Methods
This was a retrospective analysis of all patients with SLE treated with RTX at 1 center between June 2000 and December 2013. The clinical outcome was assessed by determining British Isles Lupus Assessment Group (BILAG) scores and anti–double‐stranded DNA (anti‐dsDNA) and C3 levels before and 6 months after RTX treatment. For safety analysis, adverse events and deaths were recorded.
Results
Of a total of 115 patients, 93.9% were female, the mean ± SD age at diagnosis was 26.39 ± 11.90 years, and the mean ± SD disease duration at first RTX treatment was 91.96 ± 84.80 months. A BILAG score variation of −11.26 ± 11.38 (P < 0.001) was recorded 6 months after the first RTX treatment; 40% of patients had a complete response and 27% had a partial response; in 36.5% of patients, C3 levels increased more than 25%, and in 33.5% anti‐dsDNA levels decreased more than 50%. Depletion of CD19+ cells was achieved in 94.0% of patients. Hypogammaglobulinemia was detected in 14.9% of patients, with significant reduction for IgM (P < 0.001) and IgG (P = 0.001) levels. Severe infections, infusion‐related reactions, and hypersensitivity reactions occurred in 7%, 3.5%, and 2.6% of patients, respectively. Of the 115 patients, 62 patients had repeated RTX treatments, with an average number of 1.95 ± 1.17 cycles per patient and a mean ± SD interval between infusions of 21.44 ± 20.11 months. At the end of followup, 11 patients were deceased; 6 had cardiovascular events.
Conclusion
RTX treatment was effective in decreasing disease activity, with a low incidence of adverse effects.</description><subject>Adult</subject><subject>Anti-DNA antibodies</subject><subject>CD19 antigen</subject><subject>Female</subject><subject>Humans</subject><subject>Hypersensitivity</subject><subject>Hypogammaglobulinemia</subject><subject>Immunoglobulin G</subject><subject>Immunoglobulin M</subject><subject>Immunologic Factors - therapeutic use</subject><subject>Immunosuppressive agents</subject><subject>Immunotherapy</subject><subject>Lupus</subject><subject>Lupus Erythematosus, Systemic - drug therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Retrospective Studies</subject><subject>Rituximab</subject><subject>Rituximab - therapeutic use</subject><subject>Side effects</subject><subject>Systemic lupus erythematosus</subject><issn>2151-464X</issn><issn>2151-4658</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNqNkUtLAzEQx4MoVqoHv4AEvOihNe_NeiulPqBQ8AHqJWS3E13ZR0121X57o9UeBMFcJgM__szMD6F9SoaUEHZicz9kLGV0A-0wKulAKKk3139x10N7ITyT-DjTmqfbqMcSSolK9Q56uA2AG4evirZ7Lyqb4aLG18vQQlXkeNotuoAnftk-QWXbJnThFI_wdVE_loDHULfg8eR9Ab6AOgc8e409FfgerA-7aMvZMsDed-2j27PJzfhiMJ2dX45H00EuGKUDx9Q850Il1rFEyYRYYa1kHBwnKc-ZVpmmXFExzzS4lCvpMuuIFMmcy1RI3kdHq9yFb146CK2pipBDWdoami4YqpXmTBKt_oEypZTWiY7o4S_0uel8HRcxNGVEUMnieH10vKJy34TgwZmFj1f0S0OJ-dRjoh7zpSeyB9-JXVbBfE3-yIjAyQp4K0pY_p1kRuOrVeQHYDqVyQ</recordid><startdate>201702</startdate><enddate>201702</enddate><creator>Aguiar, R.</creator><creator>Araújo, C.</creator><creator>Martins‐Coelho, G.</creator><creator>Isenberg, D.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201702</creationdate><title>Use of Rituximab in Systemic Lupus Erythematosus: A Single Center Experience Over 14 Years</title><author>Aguiar, R. ; Araújo, C. ; Martins‐Coelho, G. ; Isenberg, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4211-f26dc3467af276570a4aa523ef3093c286b813614db8ef9365fbaf0547d359453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Anti-DNA antibodies</topic><topic>CD19 antigen</topic><topic>Female</topic><topic>Humans</topic><topic>Hypersensitivity</topic><topic>Hypogammaglobulinemia</topic><topic>Immunoglobulin G</topic><topic>Immunoglobulin M</topic><topic>Immunologic Factors - therapeutic use</topic><topic>Immunosuppressive agents</topic><topic>Immunotherapy</topic><topic>Lupus</topic><topic>Lupus Erythematosus, Systemic - drug therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Retrospective Studies</topic><topic>Rituximab</topic><topic>Rituximab - therapeutic use</topic><topic>Side effects</topic><topic>Systemic lupus erythematosus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aguiar, R.</creatorcontrib><creatorcontrib>Araújo, C.</creatorcontrib><creatorcontrib>Martins‐Coelho, G.</creatorcontrib><creatorcontrib>Isenberg, D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis care & research (2010)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aguiar, R.</au><au>Araújo, C.</au><au>Martins‐Coelho, G.</au><au>Isenberg, D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Use of Rituximab in Systemic Lupus Erythematosus: A Single Center Experience Over 14 Years</atitle><jtitle>Arthritis care & research (2010)</jtitle><addtitle>Arthritis Care Res (Hoboken)</addtitle><date>2017-02</date><risdate>2017</risdate><volume>69</volume><issue>2</issue><spage>257</spage><epage>262</epage><pages>257-262</pages><issn>2151-464X</issn><eissn>2151-4658</eissn><abstract>Objective
To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or whose disease is refractory to standard immunosuppressive therapy, treated at a single center.
Methods
This was a retrospective analysis of all patients with SLE treated with RTX at 1 center between June 2000 and December 2013. The clinical outcome was assessed by determining British Isles Lupus Assessment Group (BILAG) scores and anti–double‐stranded DNA (anti‐dsDNA) and C3 levels before and 6 months after RTX treatment. For safety analysis, adverse events and deaths were recorded.
Results
Of a total of 115 patients, 93.9% were female, the mean ± SD age at diagnosis was 26.39 ± 11.90 years, and the mean ± SD disease duration at first RTX treatment was 91.96 ± 84.80 months. A BILAG score variation of −11.26 ± 11.38 (P < 0.001) was recorded 6 months after the first RTX treatment; 40% of patients had a complete response and 27% had a partial response; in 36.5% of patients, C3 levels increased more than 25%, and in 33.5% anti‐dsDNA levels decreased more than 50%. Depletion of CD19+ cells was achieved in 94.0% of patients. Hypogammaglobulinemia was detected in 14.9% of patients, with significant reduction for IgM (P < 0.001) and IgG (P = 0.001) levels. Severe infections, infusion‐related reactions, and hypersensitivity reactions occurred in 7%, 3.5%, and 2.6% of patients, respectively. Of the 115 patients, 62 patients had repeated RTX treatments, with an average number of 1.95 ± 1.17 cycles per patient and a mean ± SD interval between infusions of 21.44 ± 20.11 months. At the end of followup, 11 patients were deceased; 6 had cardiovascular events.
Conclusion
RTX treatment was effective in decreasing disease activity, with a low incidence of adverse effects.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27110698</pmid><doi>10.1002/acr.22921</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Arthritis care & research (2010), 2017-02, Vol.69 (2), p.257-262 |
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| subjects | Adult Anti-DNA antibodies CD19 antigen Female Humans Hypersensitivity Hypogammaglobulinemia Immunoglobulin G Immunoglobulin M Immunologic Factors - therapeutic use Immunosuppressive agents Immunotherapy Lupus Lupus Erythematosus, Systemic - drug therapy Male Middle Aged Monoclonal antibodies Retrospective Studies Rituximab Rituximab - therapeutic use Side effects Systemic lupus erythematosus |
| title | Use of Rituximab in Systemic Lupus Erythematosus: A Single Center Experience Over 14 Years |
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