Hypogammaglobulinemia and Infection Events in Patients with Autoimmune Diseases Treated with Rituximab: 10 Years Real-Life Experience.
Autoimmune disease
Hypogammaglobulinemia
Immunoglobulins
Rituximab
Severe infection event
Journal
Journal of clinical immunology
ISSN: 1573-2592
Titre abrégé: J Clin Immunol
Pays: Netherlands
ID NLM: 8102137
Informations de publication
Date de publication:
16 Aug 2024
16 Aug 2024
Historique:
received:
30
01
2024
accepted:
23
07
2024
medline:
16
8
2024
pubmed:
16
8
2024
entrez:
16
8
2024
Statut:
epublish
Résumé
To investigate predictors of hypogammaglobulinemia (HGG) and severe infection event (SIE) in patients with autoimmune disease (AID) receiving rituximab (RTX) therapy. This was a retrospective study conducted in a tertiary medical center in China. Predictors of HGG or SIE were assessed using Cox analysis. Restricted cubic spline (RCS) analysis was applied to examine the correlation between glucocorticoid (GC) maintenance dose and SIE. A total of 219 patients were included in this study, with a cumulative follow-up time of 698.28 person-years. Within the study population, 117 patients were diagnosed with connective tissue disease, 75 patients presented with ANCA-associated vasculitis, and 27 patients exhibited IgG4-related disease. HGG was reported in 63.3% of the patients, where an obvious decline in IgG and IgM was shown three months after RTX initiation. The rate of SIE was 7.2 per 100 person-years. An increase in the GC maintenance dose was an independent risk factor for both hypo-IgG (HR 1.07, 95% CI 1.02-1.12, p = 0.003) and SIE (HR 1.06, 95% CI 1.02-1.1, p = 0.004). Further RCS analysis identified 7.48 mg/d prednisone as a safe threshold dose for patients who underwent RTX treatment to avoid a significantly increased risk for SIE. HGG was relatively common in RTX-treated AID patients. Patients with chronic lung disease or who were taking ≥ 7.5 mg/d prednisone during RTX treatment were at increased risk for SIE and warrant attention from physicians.
Identifiants
pubmed: 39150626
doi: 10.1007/s10875-024-01773-y
pii: 10.1007/s10875-024-01773-y
doi:
Substances chimiques
Rituximab
4F4X42SYQ6
Glucocorticoids
0
Immunoglobulin G
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
179Subventions
Organisme : National High Level Hospital Clinical Research Funding
ID : 2022-PUMCH-A-041,
Organisme : National High Level Hospital Clinical Research Funding
ID : 2022-PUMCH-C-006,2022-PUMCH-B-013
Organisme : National Natural Science Foundation of China
ID : 82071839, 82271848
Organisme : CAMS Innovation Fund for Medical Sciences
ID : CIFMS 2021-1-I2M-003, 2022-I2M-C&T-B-005
Organisme : Beijing Natural Science Foundation
ID : 7232113
Organisme : National Key Research and Development Program of China
ID : 2022YFC2703100
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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