Long-term efficacy of anti-CD20 antibodies in refractory lupus nephritis

Rheumatol Int. 2012 May;32(5):1245-9. doi: 10.1007/s00296-010-1755-0. Epub 2011 Jan 22.

Abstract

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.

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage*
  • Antigens, CD20 / immunology*
  • Biomarkers / blood
  • Creatinine / blood
  • Disease Progression
  • Drug Administration Schedule
  • Drug Resistance
  • Drug Substitution
  • Female
  • Follow-Up Studies
  • Humans
  • Immunologic Factors / administration & dosage*
  • Immunosuppressive Agents / therapeutic use
  • Infusions, Intravenous
  • Kidney Failure, Chronic / etiology
  • Lupus Nephritis / complications
  • Lupus Nephritis / diagnosis
  • Lupus Nephritis / drug therapy*
  • Lupus Nephritis / immunology
  • Male
  • Mexico
  • Middle Aged
  • Prospective Studies
  • Proteinuria / drug therapy
  • Proteinuria / etiology
  • Recurrence
  • Rituximab
  • Severity of Illness Index
  • Time Factors
  • Treatment Failure
  • Young Adult

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20
  • Biomarkers
  • Immunologic Factors
  • Immunosuppressive Agents
  • Rituximab
  • Creatinine