Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids

Annals of the Rheumatic Diseases

Volumn 72, Issue 8, 2013, Pages 1280-1286

  Condon, Marie B ^a   Ashby, Damien ^a   Pepper, Ruth J ^a   Cook, H Terence ^a,b   Levy, Jeremy B ^a   Griffith, Megan ^a   Cairns, Tom D ^a   Lightstone, Liz ^a,b  

^a HAMMERSMITH HOSPITAL   (United Kingdom)

^b IMPERIAL COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; AZATHIOPRINE; CORTICOSTEROID; CREATININE; CYCLOPHOSPHAMIDE; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; HYDROXYCHLOROQUINE; METHOTREXATE; METHYLPREDNISOLONE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PREDNISOLONE; RITUXIMAB; STEROID; TACROLIMUS;

ADULT; AGED; ARTICLE; CLINICAL ARTICLE; CLINICAL PROTOCOL; COHORT ANALYSIS; CREATININE BLOOD LEVEL; DISEASE EXACERBATION; DRUG DOSE REDUCTION; DRUG DOSE TITRATION; DRUG EFFICACY; FEMALE; HOSPITAL ADMISSION; HUMAN; INFECTION; KIDNEY BIOPSY; LUPUS ERYTHEMATOSUS NEPHRITIS; MAINTENANCE THERAPY; MALE; NON INSULIN DEPENDENT DIABETES MELLITUS; OBSERVATIONAL STUDY; PATIENT SELECTION; PRIORITY JOURNAL; PROSPECTIVE STUDY; RELAPSE; REMISSION; REPEATED DRUG DOSE; SKIN LUPUS ERYTHEMATOSUS; SYSTEMIC LUPUS ERYTHEMATOSUS;

B CELLS; CORTICOSTEROIDS; LUPUS NEPHRITIS; TREATMENT;

ADULT; AGED; ANTIBODIES, MONOCLONAL, MURINE-DERIVED; COHORT STUDIES; CREATINE; DRUG SUBSTITUTION; DRUG THERAPY, COMBINATION; FEMALE; HUMANS; IMMUNOSUPPRESSIVE AGENTS; LUPUS NEPHRITIS; MALE; METHYLPREDNISOLONE; MIDDLE AGED; MYCOPHENOLIC ACID; PROSPECTIVE STUDIES; PROTEINURIA; REMISSION INDUCTION; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84880243381     PISSN: 00034967     EISSN: 14682060     Source Type: Journal    
DOI: 10.1136/annrheumdis-2012-202844     Document Type: Article

References (36)

1. Patel M, Clarke AM, Bruce IN, et al. The prevalence and incidence of biopsy-proven lupus nephritis in the UK: evidence of an ethnic gradient. Arthritis Rheum 2006;54:2963-9. (Pubitemid 44497777)
2. Lightstone L. Lupus nephritis: where are we now? Curr Opin Rheumatol 2010;22:252-6.
3. Appel GB, Contreras G, Dooley MA, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol 2009;20:1103-12.
4. Ginzler EM, Dooley MA, Aranow C, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med 2005;353:2219-28. (Pubitemid 41697285)
5. Houssiau FA, D'Cruz D, Sangle S, et al. Azathioprine versus mycophenolate mofetil for long-term immunosuppression in lupus nephritis: results from the MAINTAIN Nephritis Trial. Ann Rheum Dis 2010;69:2083-9.
6. Dooley MA, Jayne D, Ginzler EM, et al. Mycophenolate versus azathioprine as maintenance therapy for lupus nephritis. N Engl J Med 2011;365:1886-95.
7. Gladman DD, Urowitz MB, Rahman P et al. Accrual of organ damage over time in patients with systemic lupus erythematosus. J Rheumatol 2003;30:1955-9. (Pubitemid 37075543)
8. Zonana-Nacach A, Barr SG, Magder LS, et al. Damage in systemic lupus erythematosus and its association with corticosteroids. Arthritis Rheum 2000;43:1801-8. (Pubitemid 30642567)
9. Masood S, Jayne D, Karim Y Beyond immunosuppression-challenges in the clinical management of lupus nephritis. Lupus 2009;18:106-15.
10. Suleiman AB, Morad Z, Tong CT. Mortality in SLE nephritis. Ann Acad Med Singapore 1987;16:175-8.
11. Walsh M, Jayne D, Moist L, et al. Practice pattern variation in oral glucocorticoid therapy after the induction of response in proliferative lupus nephritis. Lupus 2010;19:628-33.
12. Borrows R, Loucaidou M, Van Tromp J, et al. Steroid sparing in renal transplantation with tacrolimus and mycophenolate mofetil: three-year results. Transplant Proc 2005;37:1792-4. (Pubitemid 40790833)
13. Mansfield N, Hamour S, Habib AM, et al. Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated vasculitis. Nephrol Dial Transplant 2011;26:3280-6.
14. Stone JH, Merkel PA, Spiera R, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 2010;363:221-32.
15. Pepper R, Griffith M, Kirwan C, et al. Rituximab is an effective treatment for lupus nephritis and allows a reduction in maintenance steroids. Nephrol Dial Transplant 2009;24:3717-23.
16. Fra GP, Avanzi GC, Bartoli E. Remission of refractory lupus nephritis with a protocol including rituximab. Lupus [Case Reports] 2003;12:783-7. (Pubitemid 37295815)
17. van Vollenhoven RF, Gunnarsson I, Welin-Henriksson E, et al. Biopsy-verified response of severe lupus nephritis to treatment with rituximab (anti-CD20 monoclonal antibody) plus cyclophosphamide after biopsy-documented failure to respond to cyclophosphamide alone. Scand J Rheumatol 2004;33:423-7. (Pubitemid 40006893)
18. Edelbauer M, Jungraithmayr T, Zimmerhackl LB. Rituximab in childhood systemic lupus erythematosus refractory to conventional immunosuppression: case report. Pediatr Nephrol 2005;20:811-13. (Pubitemid 40663169)
19. Leandro MJ, Cambridge G, Edwards JC, et al. B-cell depletion in the treatment of patients with systemic lupus erythematosus: a longitudinal analysis of 24 patients. Rheumatology (Oxford) 2005;44:1542-5. (Pubitemid 41742472)
20. Sfikakis PP, Boletis JN, Lionaki S, et al. Remission of proliferative lupus nephritis following B cell depletion therapy is preceded by down-regulation of the T cell costimulatory molecule CD40 ligand: an open-label trial. Arthritis Rheum 2005;52:501-13. (Pubitemid 40216314)
21. Van den Bergh B, Selleslag D, Boelaert JR, et al. Management of therapy-resistant systemic lupus erythematosus with rituximab: report of a case and review of the literature. Acta Clin Belg 2005;60:102-5. (Pubitemid 41557662)
22. Jacobson SH, van Vollenhoven R, Gunnarsson I. Rituximab-induced long-term remission of membranous lupus nephritis. Nephrol Dial Transplant 2006;21:1742-3. (Pubitemid 43834662)
23. Hay EM, Bacon PA, Gordon C, et al. The BILAG index: a reliable and valid instrument for measuring clinical disease activity in systemic lupus erythematosus. Q J Med 1993;86:447-58. (Pubitemid 23223653)
24. Moroni G, Gallelli B, Banfi G, et al. Rituximab monotherapy for remission induction of proliferative lupus nephritis flares: description of 3 cases. J Nephrol 2010;23:357-61.
25. Ezeonyeji AN, Isenberg DA. Early treatment with rituximab in newly diagnosed systemic lupus erythematosus patients: a steroid-sparing regimen. Rheumatology (Oxford) 2012;51:476-81.
26. Chan TM, Tse KC, Tang CS, et al. Long-term study of mycophenolate mofetil as continuous induction and maintenance treatment for diffuse proliferative lupus nephritis. J Am Soc Nephrol 2005;16:1076-84. (Pubitemid 41710318)
27. Houssiau FA, Vasconcelos C, D'Cruz D, et al. The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide. Ann Rheum Dis 2010;69:61-4.
28. Jonsdottir T, Sundelin B, Welin Henriksson E, et al. Rituximab-treated membranous lupus nephritis: clinical outcome and effects on electron dense deposits. Ann Rheum Dis 2011;70:1172-3.
29. Jonsdottir T, Gunnarsson I, Mourao AF, et al. Clinical improvements in proliferative vs membranous lupus nephritis following B-cell depletion: pooled data from two cohorts. Rheumatology (Oxford) 2010;49:1502-4.
30. Radhakrishnan J, Moutzouris DA, Ginzler EM, et al. Mycophenolate mofetil and intravenous cyclophosphamide are similar as induction therapy for class V lupus nephritis. Kidney Int 2010;77:152-60.
31. Venkateshan SP, Sidhu S, Malhotra S, et al. Efficacy of biologicals in the treatment of rheumatoid arthritis. a meta-analysis. Pharmacology 2009;83:1-9.
32. Posalski JD, Ishimori M, Wallace DJ, et al. Does mycophenolate mofetil prevent extra-renal flares in systemic lupus erythematosus? Results from an observational study of patients in a single practice treated for up to 5 years. Lupus 2009;18:516-21.
33. Karim MY, Alba P, Cuadrado MJ, et al. Mycophenolate mofetil for systemic lupus erythematosus refractory to other immunosuppressive agents. Rheumatology (Oxford) 2002;41:876-82.
34. Vital EM, Dass S, Buch MH, et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus. Arthritis Rheum 2011;63:3038-47.
35. Rovin BH, Furie R, Latinis K, et al. Efficacy and safety of rituximab in patients with active proliferative lupus nephritis: The Lupus Nephritis Assessment with Rituximab study. Arthritis Rheum 2012;64:1215-26.
36. Lightstone L. The landscape after LUNAR: Rituximab's crater-filled path. Arthritis Rheum 2012;64:962-5.