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

• Published in: Rheumatology international Vol. 32; no. 5; pp. 1245 - 1249
• Main Authors: Arce-Salinas, C Alejandro, Rodríguez-García, Felipe, Gómez-Vargas, J Iván
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2012; Springer Nature B.V
• Subjects: 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; Medicine; Medicine & Public Health; Mexico; Middle Aged; Original Article; Prospective Studies; Proteinuria - drug therapy; Proteinuria - etiology; Recurrence; Rheumatology; Rituximab; Severity of Illness Index; Time Factors; Treatment Failure; Young Adult; Mexico; Rituximab; SLEDAI; End-stage renal disease; B-cells; Membranous glomerulonephritis
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-010-1755-0

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.