1. Off-label use of rituximab in patients with systemic lupus erythematosus with extrarenal disease activity: a retrospective study and literature review
- Author
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Sans-Pola, Carla, Danés Carreras, Immaculada, Bosch, Josep Àngel, Marrero Álvarez, Patricia, Cortes Hernandez, Josefina, Agustí, Antònia, Institut Català de la Salut, [Sans-Pola C, Danés I, Agustí A] Servei de Farmacologia Clínica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Departament de Farmacologia, Terapèutica i Toxicologia, Universitat Autònoma de Barcelona, Bellaterra, Spain. Grup de Recerca de Farmacologia Clínica, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Bosch JÀ] Departament de Medicina Interna, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Marrero-Álvarez P] Servei de Farmàcia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cortés J] Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Immune System Diseases::Autoimmune Diseases::Lupus Erythematosus, Systemic [DISEASES] ,Otros calificadores::/uso terapéutico [Otros calificadores] ,Lupus eritematós sistèmic - Tractament ,Medicaments antineoplàstics - Ús terapèutic ,acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antineoplásicos [COMPUESTOS QUÍMICOS Y DROGAS] ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,Other subheadings::/therapeutic use [Other subheadings] ,General Medicine ,Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Antineoplastic Agents [CHEMICALS AND DRUGS] ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,enfermedades del sistema inmune::enfermedades autoinmunes::lupus eritematoso sistémico [ENFERMEDADES] - Abstract
IntroductionOff-label rituximab is commonly used for patients with systemic lupus erythematosus (SLE) with extrarenal disease activity.MethodsThe outcomes and tolerability of rituximab in adult patients with non-renal SLE treated at our hospital from 2013 to 2020 were described. Patients were followed-up until December 2021. Data were retrieved from electronic medical records. Response was classified into complete, partial or no response according to the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI 2 K)-based definitions.ResultsA total of 44 cycles were administered to 33 patients. Median age was 45 years and 97% were female. Median follow-up was 5.9 years (IQR 3.7–7.2). The most frequent symptoms that motivated rituximab use were thrombocytopenia (30.3%), arthritis (30.3%), neurological manifestations (24.2%) and cutaneous lupus (15.2%). After most treatment cycles a partial remission was achieved. The median SLEDAI-2 K score declined from 9 (IQR 5–13) to 1.5 (IQR 0–4) (p p = 0.00338. The most frequent adverse events were infusion-related reactions (18.2%) and infections (57.6%). All patients needed further treatment to maintain remission or to treat new flares.ConclusionA partial or complete response was documented after most rituximab cycles in patients with non-renal SLE. Patients with thrombocytopenia, neurolupus, and cutaneous lupus had better response than those with a predominant joint involvement.
- Published
- 2023
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