Adverse infusion reactions to rituximab in systemic lupus erythematosus: a retrospective analysis.

B cells Biologics Infusion reaction Rituximab SLE (systemic lupus Erethematosus)

Journal

BMC rheumatology
ISSN: 2520-1026
Titre abrégé: BMC Rheumatol
Pays: England
ID NLM: 101738571

Informations de publication

Date de publication:
2019
Historique:
received: 15 10 2018
accepted: 24 07 2019
entrez: 6 9 2019
pubmed: 6 9 2019
medline: 6 9 2019
Statut: epublish

Résumé

To undertake a retrospective review of patients with SLE who had received Rituximab in order to determine the rates and associated patient characteristics of clinically significant adverse infusion reactions. A descriptive analysis was undertaken of each infusion reaction, which was then assessed using the clinical information available to hypothesise on the possible underlying mechanism(s). Records of 136 SLE patients previously treated with 481 individual infusions of Rituximab were reviewed. A total of 22 patients (17.6%) had 28 (5.8% of total infusions) documented clinically significant adverse infusion reactions. Average age at first Rituximab infusion in patients without a reaction was 37 years (range 16-73) compared with 30 years (range 18-56) in those with a reaction. A high proportion of men (18.2%) experienced an infusion reaction. Severity and type of reaction varied. 6.4% of those who had a reaction were not retreated. While Rituximab remains an important tool in the treatment of SLE it is important to be aware that rates of infusion reactions may be more significant in SLE than in other diseases. A prospective study is required to better characterise the reactions.

Sections du résumé

BACKGROUND BACKGROUND
To undertake a retrospective review of patients with SLE who had received Rituximab in order to determine the rates and associated patient characteristics of clinically significant adverse infusion reactions.
METHODS METHODS
A descriptive analysis was undertaken of each infusion reaction, which was then assessed using the clinical information available to hypothesise on the possible underlying mechanism(s).
RESULTS RESULTS
Records of 136 SLE patients previously treated with 481 individual infusions of Rituximab were reviewed. A total of 22 patients (17.6%) had 28 (5.8% of total infusions) documented clinically significant adverse infusion reactions. Average age at first Rituximab infusion in patients without a reaction was 37 years (range 16-73) compared with 30 years (range 18-56) in those with a reaction. A high proportion of men (18.2%) experienced an infusion reaction. Severity and type of reaction varied. 6.4% of those who had a reaction were not retreated.
CONCLUSIONS CONCLUSIONS
While Rituximab remains an important tool in the treatment of SLE it is important to be aware that rates of infusion reactions may be more significant in SLE than in other diseases. A prospective study is required to better characterise the reactions.

Identifiants

pubmed: 31485560
doi: 10.1186/s41927-019-0082-7
pii: 82
pmc: PMC6714312
doi:

Types de publication

Journal Article

Langues

eng

Pagination

32

Déclaration de conflit d'intérêts

Competing interestsAH - received financial support to attend international conferences from Bristol Myers Squibb. JL- nil to disclose. GC - nil to disclose. DI - Professor Isenberg has received honoraria from Merck Serono, Eli Lilly, XTLBio, Anthera, Celegene and UCB Pharma. These honoraria are passed onto a local arthritis charity. ML - Dr. Leandro has received honoraria for professional meeting participation from Roche UK, Roche Brazil, and Roche Portugal (less than $10,000 each), support for conference attendance from Roche and Chugai UK.

Références

Blood. 1999 Oct 1;94(7):2217-24
pubmed: 10498591
Arthritis Rheum. 2002 Oct;46(10):2673-7
pubmed: 12384926
J Allergy Clin Immunol. 2004 Aug;114(2):371-6
pubmed: 15316518
J Allergy Clin Immunol. 2005 Oct;116(4):900-5
pubmed: 16210067
N Engl J Med. 2006 Sep 7;355(10):1018-28
pubmed: 16908486
J Immunotoxicol. 2008 Jan;5(1):11-5
pubmed: 18382853
J Allergy Clin Immunol. 2008 Sep;122(3):574-80
pubmed: 18502492
Allergy. 2008 Nov;63(11):1418-27
pubmed: 18925878
J Allergy Clin Immunol. 2009 Dec;124(6):1259-66
pubmed: 19910036
Nat Rev Rheumatol. 2009 Dec;5(12):711-6
pubmed: 19946298
Allergy. 2010 May;65(5):657-61
pubmed: 19951375
Arthritis Rheum. 2010 Jan;62(1):222-33
pubmed: 20039413
Arthritis Rheum. 2010 Aug;62(8):2458-66
pubmed: 20506527
Allergy. 2010 Nov;65(11):1357-66
pubmed: 20716314
Eur J Dermatol. 2011 Sep-Oct;21(5):667-74
pubmed: 21742594
Rheumatol Int. 2013 Feb;33(2):529-33
pubmed: 22068354
Arthritis Rheum. 2012 Apr;64(4):1215-26
pubmed: 22231479
Arthritis Care Res (Hoboken). 2012 Jun;64(6):797-808
pubmed: 22556106
Int Arch Allergy Immunol. 2012;159(3):321-6
pubmed: 22846615
Arthritis Res Ther. 2013;15 Suppl 1:S2
pubmed: 23566295
Oncoimmunology. 2013 Oct 1;2(10):e26333
pubmed: 24251081
Immunol Allergy Clin North Am. 2014 Aug;34(3):615-32, ix
pubmed: 25017680
J Allergy Clin Immunol Pract. 2015 Mar-Apr;3(2):175-85; quiz 186
pubmed: 25754718
Arthritis Rheumatol. 2015 May;67(8):2046-55
pubmed: 25916583
J Rheumatol. 2015 Oct;42(10):1761-6
pubmed: 26276965
Rheumatology (Oxford). 2016 Aug;55(8):1357-63
pubmed: 26589244
Arthritis Care Res (Hoboken). 2017 Feb;69(2):257-262
pubmed: 27110698
J Allergy Clin Immunol Pract. 2017 Jan - Feb;5(1):107-113.e1
pubmed: 27497683
Ann Allergy Asthma Immunol. 2016 Sep;117(3):273-9
pubmed: 27613461
Leuk Lymphoma. 2017 Nov;58(11):2633-2641
pubmed: 28367662
Rheumatology (Oxford). 2017 Jul 1;56(7):1227-1237
pubmed: 28407142
Rheumatology (Oxford). 2018 Jan 1;57(1):e1-e45
pubmed: 29029350
Ann Rheum Dis. 2019 Aug;78(8):1140-1142
pubmed: 30923233

Auteurs

Ashleigh Hennessey (A)

Rheumatology Department, Royal Brisbane and Women's Hopsital, Herston, Brisbane, Queensland 4006 Australia.
2University of Queensland School of Medicine, Herston, Brisbane, Queensland 4006 Australia.

Joanna Lukawska (J)

3Allergy Medicine, University College London Hospitals, London, UK.

Geraldine Cambridge (G)

4Centre for Rheumatology and Bloomsbury Rheumatology Unit, University College London, London, UK.

David Isenberg (D)

5Division of Rheumatology, Department of Medicine, University College London Hospitals & Centre for Rheumatology, London, UK.
6Bloomsbury, Rheumatology Unit, University College London, London, UK.

Maria Leandro (M)

5Division of Rheumatology, Department of Medicine, University College London Hospitals & Centre for Rheumatology, London, UK.
6Bloomsbury, Rheumatology Unit, University College London, London, UK.

Classifications MeSH