Abstract
Objective: To compare the clinical results after treatment with B-cell depleting therapy in patients with membranous (WHO Class V) vs proliferative (WHO Class III or IV) lupus nephritis (LN). Methods: Data were compiled from two European centres on all patients with LN who were treated with i.v. rituximab (RTX) in a combination protocol with i.v. cyclophosphamide and steroids. Laboratory and serological evaluations were performed at 3, 6 and 12 months of follow-up. No immunosuppressive drugs were given before B-cell repopulation. Results: Forty-three patients, 28 with proliferate and 15 with membranous LN by renal biopsy, were evaluated. Six months after treatment with RTX, both the membranous and the proliferative LN patients had a significant reduction in proteinuria and an increase in serum albumin. The main improvements were observed during the first 6 months and only minor non-significant changes in albumin and proteinuria were observed thereafter. As expected, the patients with membranous nephritis had lower anti-dsDNA titres and higher complement C3 levels at baseline, but in both groups a significant reduction in anti t-dsDNA itre and improvements in complement C3 levels were seen during the first 6 months after treatment; the kinetics of improvement were similar in both groups. Conclusion: The clinical course following B-cell depleting therapy is strikingly similar between patients with membranous and those with proliferative LN. These observational data suggest that, if controlled studies confirm the efficacy of B-cell depleting therapy in proliferative nephritis, clinicians may reasonably consider such therapy in membranous LN.
Original language | English |
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Article number | keq055 |
Pages (from-to) | 1502-1504 |
Number of pages | 3 |
Journal | Rheumatology |
Volume | 49 |
Issue number | 8 |
DOIs | |
Publication status | Published - 27 Apr 2010 |
Bibliographical note
Funding Information:Funding: Supported by a grant from King Gustaf V’s 80th Birthday Fund and by funds from the Karolinska Institutet.
Other keywords
- Anti-CD20
- Lupus nephritis
- Rituximab
- Systemic lupus erythematosus
- Treatment