Effectiveness and Safety of Rituximab in Systemic Lupus Erythematosus: A Case Series Describing the Experience of 2 Centers.
Efectividad y seguridad de rituximab en el lupus eritematoso sistémico. Serie de casos. Experiencia de 2 centros.
Autoimmune diseases
B-lymphocytes
Efectividad
Effectiveness
Enfermedades autoinmunes
Linfocitos B
Lupus eritematoso sistémico
Rituximab
Safety
Seguridad
Systemic lupus erythematosus
Journal
Reumatologia clinica
ISSN: 2173-5743
Titre abrégé: Reumatol Clin (Engl Ed)
Pays: Spain
ID NLM: 101717526
Informations de publication
Date de publication:
Historique:
received:
22
09
2017
revised:
01
05
2018
accepted:
02
08
2018
pubmed:
14
12
2018
medline:
3
9
2021
entrez:
8
12
2018
Statut:
ppublish
Résumé
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems. B cells have a critical role in the pathogenesis of SLE. Rituximab (RTX) is a drug composed of chimeric monoclonal antibodies against the CD20 protein, producing a depletion of B lymphocytes. To analyze the effectiveness and safety of RTX in patients with SLE in clinical practice. Collection of retrospective variables of the medical records of 20 patients with SLE treated with RTX in 2hospitals (Hospital de la Santa Creu i Sant Pau, and Hospital del Mar, in Barcelona, Spain). We evaluated demographic, clinical, serological and treatment variables. There was a statistically significant association in the following variables collected in the study before and after treatment: there was a decrease in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (P<.001), erythrocyte sedimentation rate (P=.017), use of glucocorticoids (P=.025) and IgM values (P=.031), as well as an increase in the C4 values (P=.014) after treatment with RTX. A patient with SLE, antiphospholipid syndrome, complex comorbidity and multiorgan lupus involvement died after developing a septic process, months after receiving a single treatment cycle with RTX. Although RTX currently has no official indication approved for SLE, our data suggest that it may be effective in reducing the activity of the disease and as a steroid-sparing agent, with an acceptable safety profile. However, larger follow-up periods with a greater number of patients are needed to solve the remaining doubts about the use of RTX in SLE.
Sections du résumé
BACKGROUND
BACKGROUND
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems. B cells have a critical role in the pathogenesis of SLE. Rituximab (RTX) is a drug composed of chimeric monoclonal antibodies against the CD20 protein, producing a depletion of B lymphocytes.
OBJECTIVE
OBJECTIVE
To analyze the effectiveness and safety of RTX in patients with SLE in clinical practice.
METHODS
METHODS
Collection of retrospective variables of the medical records of 20 patients with SLE treated with RTX in 2hospitals (Hospital de la Santa Creu i Sant Pau, and Hospital del Mar, in Barcelona, Spain). We evaluated demographic, clinical, serological and treatment variables.
RESULTS
RESULTS
There was a statistically significant association in the following variables collected in the study before and after treatment: there was a decrease in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (P<.001), erythrocyte sedimentation rate (P=.017), use of glucocorticoids (P=.025) and IgM values (P=.031), as well as an increase in the C4 values (P=.014) after treatment with RTX. A patient with SLE, antiphospholipid syndrome, complex comorbidity and multiorgan lupus involvement died after developing a septic process, months after receiving a single treatment cycle with RTX.
CONCLUSIONS
CONCLUSIONS
Although RTX currently has no official indication approved for SLE, our data suggest that it may be effective in reducing the activity of the disease and as a steroid-sparing agent, with an acceptable safety profile. However, larger follow-up periods with a greater number of patients are needed to solve the remaining doubts about the use of RTX in SLE.
Identifiants
pubmed: 30522941
pii: S1699-258X(18)30192-X
doi: 10.1016/j.reuma.2018.08.012
pii:
doi:
Substances chimiques
Immunologic Factors
0
Rituximab
4F4X42SYQ6
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
391-395Informations de copyright
Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.