PMID- 25117653
OWN - NLM
STAT- MEDLINE
DCOM- 20150824
LR  - 20151119
IS  - 1477-0962 (Electronic)
IS  - 0961-2033 (Linking)
VI  - 24
IP  - 1
DP  - 2015 Jan
TI  - The indications, efficacy and adverse events of rituximab in a large cohort of 
      patients with juvenile-onset SLE.
PG  - 10-7
LID - 10.1177/0961203314547793 [doi]
AB  - BACKGROUND: B cells drive antibody formation and T cell activation. This study 
      aimed to describe the clinical indications, efficacy and adverse events (AEs) for 
      the B-cell depleting agent, rituximab, in a large cohort of children with lupus. 
      METHODS: Prescribing records and the UK JSLE Cohort Study database identified 
      rituximab use. RESULTS: Sixty-three patients received 104 courses of intravenous 
      rituximab over a 10-year period. Patients were aged 12.2 (IQR 9.0-13.9) years at 
      diagnosis and 50 (79%) were female. They had disease for 1.4 (0.2-3.0) years at 
      the time of rituximab. Lupus nephritis was the most common indication (36% of 
      first courses). Clinical biomarkers, 2.5 (1.6-4.3) months after treatment, 
      demonstrated a statistically significant improvement in ESR, C3, C4, creatinine, 
      albumin, haemoglobin, anti-dsDNA titres and urine albumin:creatinine ratio. IgG, 
      IgA and IgM levels decreased (p < 0.01). Oral corticosteroid dose significantly 
      reduced after rituximab (dose before 0.26 (0.09-0.44) mg/kg, after 0.17 
      (0.09-0.30) mg/kg; p = 0.01)). AEs occurred in 19 (18%) of all courses including; 
      delayed second dose (8%), Ig replacement (2%) and infusion reactions (6%; 
      anaphylaxis 2%). The global BILAG score showed a trend toward improvement (before 
      4.5 (2.0-9.0), after 3.0 (2.0-5.0); p = 0.16). CONCLUSION: Rituximab improves 
      disease activity in children with lupus and serious AEs are infrequent. 
      Controlled studies are required.
CI  - (c) The Author(s) 2014 Reprints and permissions: 
      sagepub.co.uk/journalsPermissions.nav.
FAU - Watson, L
AU  - Watson L
AD  - Department of Women's and Children's Health, Institute of Translational Medicine, 
      University of Liverpool, UK Department of Paediatric Nephrology, Alder Hey 
      Children's NHS Foundation Trust Hospital, Liverpool, UK 
      louise.watson@liverpool.ac.uk.
FAU - Beresford, M W
AU  - Beresford MW
AD  - Department of Women's and Children's Health, Institute of Translational Medicine, 
      University of Liverpool, UK Department of Paediatric Rheumatology, Alder Hey 
      Children's NHS Foundation Trust Hospital, Liverpool, UK.
FAU - Maynes, C
AU  - Maynes C
AD  - Department of Paediatric Nephrology, Great Ormond Street Hospital for Children 
      NHS Foundation Trust, London UK.
FAU - Pilkington, C
AU  - Pilkington C
AD  - Department of Paediatric Rheumatology, Great Ormond Street Hospital for Children 
      NHS Foundation Trust, London UK.
FAU - Marks, S D
AU  - Marks SD
AD  - Department of Paediatric Nephrology, Great Ormond Street Hospital for Children 
      NHS Foundation Trust, London UK.
FAU - Glackin, Y
AU  - Glackin Y
AD  - Department of Paediatric Rheumatology, Great Ormond Street Hospital for Children 
      NHS Foundation Trust, London UK.
FAU - Tullus, K
AU  - Tullus K
AD  - Department of Paediatric Nephrology, Great Ormond Street Hospital for Children 
      NHS Foundation Trust, London UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140812
PL  - England
TA  - Lupus
JT  - Lupus
JID - 9204265
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Biomarkers)
RN  - 0 (Complement C3)
RN  - 0 (Complement C4)
RN  - 0 (Hemoglobins)
RN  - 0 (Immunoglobulins)
RN  - 0 (Immunologic Factors)
RN  - 0 (Serum Albumin)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 9007-49-2 (DNA)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adolescent
MH  - Adrenal Cortex Hormones/therapeutic use
MH  - Albuminuria/urine
MH  - Antibodies, Antinuclear/blood
MH  - Antibodies, Monoclonal, Murine-Derived/adverse effects/*therapeutic use
MH  - *B-Lymphocytes
MH  - Biomarkers/blood/urine
MH  - Blood Sedimentation
MH  - Child
MH  - Complement C3/metabolism
MH  - Complement C4/metabolism
MH  - Creatinine/blood/urine
MH  - DNA/immunology
MH  - Female
MH  - Hemoglobins/metabolism
MH  - Humans
MH  - Immunoglobulins/blood
MH  - Immunologic Factors/adverse effects/*therapeutic use
MH  - Lupus Erythematosus, Systemic/blood/*drug therapy
MH  - Lymphocyte Count
MH  - Male
MH  - Retrospective Studies
MH  - Rituximab
MH  - Serum Albumin/metabolism
OTO - NOTNLM
OT  - B-cell depletion
OT  - Rituximab
OT  - SLE
OT  - child
OT  - lupus
EDAT- 2014/08/15 06:00
MHDA- 2015/08/25 06:00
CRDT- 2014/08/14 06:00
PHST- 2014/08/14 06:00 [entrez]
PHST- 2014/08/15 06:00 [pubmed]
PHST- 2015/08/25 06:00 [medline]
AID - 0961203314547793 [pii]
AID - 10.1177/0961203314547793 [doi]
PST - ppublish
SO  - Lupus. 2015 Jan;24(1):10-7. doi: 10.1177/0961203314547793. Epub 2014 Aug 12.