Complete remission of lupus nephritis with rituximab and steroids for induction and rituximab alone for maintenance therapy

Am J Kidney Dis. 2008 Aug;52(2):346-52. doi: 10.1053/j.ajkd.2008.03.036. Epub 2008 Jun 24.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Biopsy
  • Cell Proliferation
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / therapeutic use*
  • Infusions, Intravenous
  • Kidney / pathology
  • Lupus Nephritis / drug therapy*
  • Lupus Nephritis / pathology
  • Microscopy, Fluorescence
  • Remission Induction
  • Rituximab
  • Severity of Illness Index
  • Time Factors

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Glucocorticoids
  • Immunologic Factors
  • Rituximab