PMID- 16947528
OWN - NLM
STAT- MEDLINE
DCOM- 20061108
LR  - 20151119
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 54
IP  - 9
DP  - 2006 Sep
TI  - Long-term comparison of rituximab treatment for refractory systemic lupus 
      erythematosus and vasculitis: Remission, relapse, and re-treatment.
PG  - 2970-82
AB  - OBJECTIVE: Current treatments for systemic lupus erythematosus (SLE) and 
      vasculitis contribute to mortality and incapacity and are only partially 
      effective; thus, newer therapies are clearly needed. Depletion of B cells has led 
      to disease control in patients with autoimmune disorders. We sought to assess the 
      long-term efficacy and safety of a B cell-depleting therapy in patients with SLE 
      and patients with vasculitis. METHODS: In a prospective study with a median 
      followup of 24 months, 11 patients with active or refractory SLE and 11 patients 
      with active or refractory antineutrophil cytoplasmic antibody-associated 
      vasculitis (AAV) received a course of therapy with rituximab (an anti-CD20 
      monoclonal antibody) along with a single dose of intravenous cyclophosphamide. 
      RESULTS: Remission followed rapid B cell depletion, with response rates of 100% 
      among the 11 patients with SLE (6 patients had a complete response, and 5 
      patients had a partial response) and 91% among the 11 patients with AAV (9 
      patients had a complete response, and 1 patient had partial remission). A renal 
      response occurred in all 6 patients with lupus nephritis. Clinical improvement 
      was accompanied by significant reductions in the daily dose of prednisolone. 
      Relapse occurred in 64% of the patients with SLE and in 60% of those with AAV. B 
      cell return preceded relapse in the majority of patients, and further treatment 
      with rituximab proved effective. IgG and IgM levels were maintained in the normal 
      range. The incidence of infective complications was low; however, infusion 
      reactions were common, and human antichimeric antibodies developed in 5 of 14 
      patients. CONCLUSION: B cell depletion offers the prospect of sustained disease 
      remission and improved disease control combined with low toxicity in patients 
      with active or refractory SLE or AAV. Relapse following treatment is common, but 
      re-treatment is rapidly effective.
FAU - Smith, K G C
AU  - Smith KG
AD  - University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, 
      Cambridge, UK. hgcs2@cam.ac.uk
FAU - Jones, R B
AU  - Jones RB
FAU - Burns, S M
AU  - Burns SM
FAU - Jayne, D R W
AU  - Jayne DR
LA  - eng
GR  - 067543AIA/Wellcome Trust/United Kingdom
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Antirheumatic Agents)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Murine-Derived
MH  - Antirheumatic Agents/*therapeutic use
MH  - B-Lymphocytes/drug effects/immunology
MH  - Female
MH  - Humans
MH  - Lupus Erythematosus, Systemic/*drug therapy
MH  - Lymphocyte Depletion
MH  - Male
MH  - Middle Aged
MH  - Rituximab
MH  - Vasculitis/*drug therapy
EDAT- 2006/09/02 09:00
MHDA- 2006/11/10 09:00
CRDT- 2006/09/02 09:00
PHST- 2006/09/02 09:00 [pubmed]
PHST- 2006/11/10 09:00 [medline]
PHST- 2006/09/02 09:00 [entrez]
AID - 10.1002/art.22046 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2006 Sep;54(9):2970-82. doi: 10.1002/art.22046.