Rituximab Therapy in Lupus Nephritis: Current Clinical Evidence

Manuel Ramos-Casals; Candido Diaz-Lagares; Maria-Jose Soto-Cardenas; Pilar Brito-Zeron; Maria-Jose Cuadrado; Giovanni Sanna; Laura Bertolaccini; Munther A. Khamashta

doi:10.1007/s12016-010-8205-3

Rituximab Therapy in Lupus Nephritis: Current Clinical Evidence

Manuel Ramos-Casals, Candido Diaz-Lagares, Maria-Jose Soto-Cardenas, Pilar Brito-Zeron, Maria-Jose Cuadrado, Giovanni Sanna, Laura Bertolaccini, Munther A. Khamashta

Women & Children's Health

Research output: Contribution to journal › Literature review › peer-review

32 Citations (Scopus)

Abstract

The complexity of the therapeutic approach in lupus nephritis (LN) is increased by the large number of patients who do not respond to first-line therapies and by relapses after initial clinical remission. The emergence of biological agents has increased the therapeutic armamentarium available in these complex situations, but their use is limited by the lack of licensing. We analysed current evidence on the therapeutic use of rituximab in adult LN patients by systematic analysis of seven observational studies published since 2005 (four in 2009), which included 106 LN patients treated with rituximab. A complete or partial therapeutic response was achieved in 73 (69%) patients. The response according to the type of LN was stated in 79 cases: 8 (80%) patients with type III LN had a favourable, 26 (67%) of those with type IV, 4 (57%) of those with type V and 18 (78%) of those with mixed membranous-proliferative LN. The main factors associated with no response were younger age, black race and lack of CD19(+) cell depletion. The lowest rates of complete response were observed in patients with type V LN, especially those with associated proliferative lesions. Although it is not yet possible to make definite recommendations, the global analysis of these cases supports the off-label use of rituximab in severe, refractory LN cases.

Original language	English
Pages (from-to)	159 - 169
Number of pages	11
Journal	Clinical Reviews in Allergy and Immunology
Volume	40
Issue number	3
DOIs	https://doi.org/10.1007/s12016-010-8205-3
Publication status	Published - Jun 2011

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title = "Rituximab Therapy in Lupus Nephritis: Current Clinical Evidence",

abstract = "The complexity of the therapeutic approach in lupus nephritis (LN) is increased by the large number of patients who do not respond to first-line therapies and by relapses after initial clinical remission. The emergence of biological agents has increased the therapeutic armamentarium available in these complex situations, but their use is limited by the lack of licensing. We analysed current evidence on the therapeutic use of rituximab in adult LN patients by systematic analysis of seven observational studies published since 2005 (four in 2009), which included 106 LN patients treated with rituximab. A complete or partial therapeutic response was achieved in 73 (69%) patients. The response according to the type of LN was stated in 79 cases: 8 (80%) patients with type III LN had a favourable, 26 (67%) of those with type IV, 4 (57%) of those with type V and 18 (78%) of those with mixed membranous-proliferative LN. The main factors associated with no response were younger age, black race and lack of CD19(+) cell depletion. The lowest rates of complete response were observed in patients with type V LN, especially those with associated proliferative lesions. Although it is not yet possible to make definite recommendations, the global analysis of these cases supports the off-label use of rituximab in severe, refractory LN cases.",

author = "Manuel Ramos-Casals and Candido Diaz-Lagares and Maria-Jose Soto-Cardenas and Pilar Brito-Zeron and Maria-Jose Cuadrado and Giovanni Sanna and Laura Bertolaccini and Khamashta, {Munther A.}",

year = "2011",

month = jun,

doi = "10.1007/s12016-010-8205-3",

language = "English",

volume = "40",

pages = "159 -- 169",

journal = "Clinical Reviews in Allergy and Immunology",

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T1 - Rituximab Therapy in Lupus Nephritis: Current Clinical Evidence

AU - Ramos-Casals, Manuel

AU - Diaz-Lagares, Candido

AU - Soto-Cardenas, Maria-Jose

AU - Brito-Zeron, Pilar

AU - Cuadrado, Maria-Jose

AU - Sanna, Giovanni

AU - Bertolaccini, Laura

AU - Khamashta, Munther A.

PY - 2011/6

Y1 - 2011/6

N2 - The complexity of the therapeutic approach in lupus nephritis (LN) is increased by the large number of patients who do not respond to first-line therapies and by relapses after initial clinical remission. The emergence of biological agents has increased the therapeutic armamentarium available in these complex situations, but their use is limited by the lack of licensing. We analysed current evidence on the therapeutic use of rituximab in adult LN patients by systematic analysis of seven observational studies published since 2005 (four in 2009), which included 106 LN patients treated with rituximab. A complete or partial therapeutic response was achieved in 73 (69%) patients. The response according to the type of LN was stated in 79 cases: 8 (80%) patients with type III LN had a favourable, 26 (67%) of those with type IV, 4 (57%) of those with type V and 18 (78%) of those with mixed membranous-proliferative LN. The main factors associated with no response were younger age, black race and lack of CD19(+) cell depletion. The lowest rates of complete response were observed in patients with type V LN, especially those with associated proliferative lesions. Although it is not yet possible to make definite recommendations, the global analysis of these cases supports the off-label use of rituximab in severe, refractory LN cases.

AB - The complexity of the therapeutic approach in lupus nephritis (LN) is increased by the large number of patients who do not respond to first-line therapies and by relapses after initial clinical remission. The emergence of biological agents has increased the therapeutic armamentarium available in these complex situations, but their use is limited by the lack of licensing. We analysed current evidence on the therapeutic use of rituximab in adult LN patients by systematic analysis of seven observational studies published since 2005 (four in 2009), which included 106 LN patients treated with rituximab. A complete or partial therapeutic response was achieved in 73 (69%) patients. The response according to the type of LN was stated in 79 cases: 8 (80%) patients with type III LN had a favourable, 26 (67%) of those with type IV, 4 (57%) of those with type V and 18 (78%) of those with mixed membranous-proliferative LN. The main factors associated with no response were younger age, black race and lack of CD19(+) cell depletion. The lowest rates of complete response were observed in patients with type V LN, especially those with associated proliferative lesions. Although it is not yet possible to make definite recommendations, the global analysis of these cases supports the off-label use of rituximab in severe, refractory LN cases.

U2 - 10.1007/s12016-010-8205-3

DO - 10.1007/s12016-010-8205-3

M3 - Literature review

VL - 40

SP - 159

EP - 169

JO - Clinical Reviews in Allergy and Immunology

JF - Clinical Reviews in Allergy and Immunology

IS - 3

ER -

Rituximab Therapy in Lupus Nephritis: Current Clinical Evidence

Abstract

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