Skip Navigation


NDT Advance Access originally published online on January 29, 2009
Nephrology Dialysis Transplantation 2009 24(7):2157-2160; doi:10.1093/ndt/gfp002
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
24/7/2157    most recent
gfp002v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Boletis, J. N.
Right arrow Articles by Sfikakis, P. P.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Boletis, J. N.
Right arrow Articles by Sfikakis, P. P.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Rituximab and mycophenolate mofetil for relapsing proliferative lupus nephritis: a long-term prospective study

John N. Boletis1, Smaragde Marinaki1, Chryssanthe Skalioti1, Sofia S. Lionaki1, Aliki Iniotaki2 and Petros P. Sfikakis3

1 Nephrology Department, Laikon Hospital 2 Immunology Department, Gennimatas Hospital 3 First Department of Propedeutic and Internal Medicine, Athens University Medical School, Athens, Greece

Correspondence and offprint requests to: John N. Boletis; E-mail: laikneph{at}laiko.gr



  Abstract

Background. Subsequent to cyclophosphamide-based induction therapy of lupus nephritis, and despite maintenance chronic immunosuppressive treatment, many patients experience relapses.

Methods. This prospective, observational study included 10 women with biopsy-proven relapse of proliferative lupus nephritis occurring during maintenance with mycophenolate mofetil (MMF) or azathioprine. The long-term outcome after a single course of the B-cell depleting anti-CD20 antibody rituximab (4 weekly infusions of 375 mg/m2), combined with daily MMF (2 g) and prednisolone (0.5 mg/ kg/day for 4 weeks, tapered thereafter) is presented.

Results. While renal function was not severely impaired at baseline, partial remission (>50% improvement in all abnormal renal parameters) was achieved in eight patients at a median of 3.5 months. In seven patients, with 24-h urinary protein of 2.5 ± 1.1 g (mean ± SD), complete remission, associated with increases in serum complement levels and decreases in anti-dsDNA titres, was subsequently established (normal serum creatinine/albumin levels, inactive urine sediment and 24-h urinary protein <0.5 g). Complete nephritis remission was sustained at the follow-up end (median of 38 months) in six patients. Combination treatment was well tolerated.

Conclusions. The efficacy of this low-toxicity combination was particularly evident in patients with subnephrotic proteinuria due to proliferative lupus nephritis relapse. Controlled trials to define the role of rituximab/MMF in this condition are warranted.

Keywords: CD20; mycophenolate mofetil; nephritis; relapse; rituximab; systemic lupus erythematosus

Received for publication: 16.10.08
Accepted in revised form: 31.12.08


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.