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Rituximab May Be Effective for Severe Lupus Nephritis

Long-term outcomes are positive in patients who achieve early B-cell depletion

THURSDAY, Mar. 5 (HealthDay News) -- In patients with relapsing or refractory lupus nephritis, rituximab may be an effective treatment if early B-cell depletion is achieved, according to research published online Mar. 4 in the Clinical Journal of the American Society of Nephrology.

Catherine Melander, M.D., of the Universite Paris Descartes, Hopital Necker in Paris, France, and colleagues studied 20 patients -- 19 women and one man -- who were treated with rituximab and followed for at least 12 months. Subjects included six relapsing cases, 12 refractory cases, and two cases who received rituximab as front-line treatment.

After a median follow-up of 22 months, the researchers found that 12 patients (60 percent) achieved a partial or complete renal remission. They observed a lupus nephritis relapse in one patient, who responded to a new course of rituximab. The investigators also found that black patients were less likely to achieve B-cell depletion after one month, which was associated with a poor outcome. Hypoalbuminemia also was associated with a poor outcome, the report indicates.

"Prospective studies assessing the efficiency of rituximab, with or without cyclophosphamide, in severe lupus nephritis are warranted," the authors conclude.

Abstract
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