PMID- 38242722
OWN - NLM
STAT- MEDLINE
DCOM- 20240122
LR  - 20240131
IS  - 2053-8790 (Print)
IS  - 2053-8790 (Electronic)
IS  - 2053-8790 (Linking)
VI  - 11
IP  - 1
DP  - 2024 Jan 19
TI  - Rituximab as an effective add-on maintenance therapy for disease activities in 
      childhood-onset systemic lupus erythematosus.
LID - 10.1136/lupus-2023-000987 [doi]
LID - e000987
AB  - OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic inflammatory 
      autoimmune disease that can result in high morbidity if not treated. This 
      retrospective study aimed to evaluate the outcomes of rituximab treatment in a 
      paediatric SLE cohort in Taiwan. METHODS: The medical records of paediatric 
      patients diagnosed with SLE at the National Taiwan University Hospital between 
      January 1992 and August 2022 who received rituximab as maintenance therapy 
      between January 2015 and August 2022 were retrospectively reviewed. To enhance 
      our analysis, we included a contemporary comparison group, matching in case 
      number and demographic characteristics. This study aimed to describe the 
      indications, efficacy and safety of rituximab in the treatment of paediatric SLE 
      and to analyse the factors associated with disease outcomes. RESULTS: The study 
      included 40 rituximab-treated patients with a median age of 14.3 years at the 
      time of disease diagnosis. In the rituximab-treated cohort, the median score on 
      the Systemic Lupus Erythematosus Disease Activity Index 2000 decreased from 8 
      before rituximab administration to 4 after 2 years. The levels of C3 and C4 
      increased and anti-double stranded DNA (anti-dsDNA) levels decreased 
      significantly within 6 months. The equivalent oral prednisolone dose halved after 
      6 months. Finally, 8 (20%) patients achieved disease control and 35 (87.5%) 
      patients had no flare-ups during the follow-up period (median, 2 years). Those 
      patients who achieved disease control had a significantly shorter interval 
      between diagnosis and rituximab administration. In terms of adverse effects, only 
      one patient developed hypogammaglobulinaemia that required intravenous 
      immunoglobulin (IVIG) replacement. Compared with the comparison group (n=53), the 
      rituximab-treated cohort exhibited superior disease outcomes and a reduced 
      incidence of flare-ups. CONCLUSIONS: This study provides real-world data and 
      illuminates rituximab's role in maintaining disease stability among patients with 
      paediatric-onset SLE who are serologically active without major clinical 
      deterioration. Most importantly, no mortality or development of end-stage renal 
      disease was observed in the rituximab-treated cohort.
CI  - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Lin, Ting-Wei
AU  - Lin TW
AD  - Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
FAU - Lin, Yu-Tsan
AU  - Lin YT
AD  - Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
FAU - Hu, Ya-Chiao
AU  - Hu YC
AD  - Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
FAU - Yu, Hsin-Hui
AU  - Yu HH
AD  - Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
FAU - Chiang, Bor-Luen
AU  - Chiang BL
AUID- ORCID: 0000-0002-6705-0286
AD  - Pediatrics, National Taiwan University Hospital, Taipei, Taiwan 
      gicmbor@ntu.edu.tw.
AD  - Genome and Systems Biology Degree Program, College of Life Science, National 
      Taiwan University, Taipei, Taiwan.
AD  - Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20240119
PL  - England
TA  - Lupus Sci Med
JT  - Lupus science & medicine
JID - 101633705
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
SB  - IM
MH  - Humans
MH  - Child
MH  - Adolescent
MH  - Rituximab/adverse effects
MH  - *Lupus Erythematosus, Systemic/complications/drug therapy/diagnosis
MH  - Retrospective Studies
MH  - Antibodies, Monoclonal, Murine-Derived/adverse effects
MH  - Treatment Outcome
PMC - PMC10806525
OTO - NOTNLM
OT  - autoimmune diseases
OT  - biological products
OT  - lupus erythematosus, systemic
COIS- Competing interests: None declared.
EDAT- 2024/01/20 05:42
MHDA- 2024/01/22 06:43
PMCR- 2024/01/19
CRDT- 2024/01/19 21:42
PHST- 2023/06/27 00:00 [received]
PHST- 2023/12/23 00:00 [accepted]
PHST- 2024/01/22 06:43 [medline]
PHST- 2024/01/20 05:42 [pubmed]
PHST- 2024/01/19 21:42 [entrez]
PHST- 2024/01/19 00:00 [pmc-release]
AID - 11/1/e000987 [pii]
AID - lupus-2023-000987 [pii]
AID - 10.1136/lupus-2023-000987 [doi]
PST - epublish
SO  - Lupus Sci Med. 2024 Jan 19;11(1):e000987. doi: 10.1136/lupus-2023-000987.