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Why do some patients with systemic lupus erythematosus fail to respond to B-cell depletion using rituximab

Freitas, S; Mozo Ruiz, M; Costa Carneiro, A; Isenberg, DA; (2020) Why do some patients with systemic lupus erythematosus fail to respond to B-cell depletion using rituximab. Clinical and Experimental Rheumatology , 38 pp. 262-266. Green open access

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Abstract

Introduction The Centre for Rheumatology has treated 165 lupus patients with Rituximab since 2000. Our aim was to identify patients who failed to respond, identify any obvious distinguishing features, and to optimize individual patient treatment. Methods We reviewed all 165 lupus patients treated with Rituximab and reviewed the data up to 6 months after treatment. We excluded those who developed allergic reactions, had discoid lupus only or were lost follow-up. We assessed patients with active disease after 6 months, using the British Isles Lupus Assessment Group (BILAG) disease activity scores. Those patients whose A and B scores did not decrease, were deemed to have failed to respond. Results 144 patients were included in the final analysis. The median disease duration was 6.68 (IQR 2.32-11.90) years. 13.9% of the patients failed to decrease their BILAG scores. Two of the 144 patients died during the 6 months after treatment. The median BILAG at baseline was lower in the failure group (8.50, SD 6.00-12.75) at the time of treatment as opposed to those patients who improved (17, SD12.0-23.0) (p<0.001). We found that patients with renal involvement failed less often than those without it (p=0.021). No other significant differences were observed. Conclusions Patients with a lower BILAG score are less likely to benefit from RTX treatment. Patients with renal involvement were less likely to fail to respond to RTX. We could not identify other features predictive of failure.

Type: Article
Title: Why do some patients with systemic lupus erythematosus fail to respond to B-cell depletion using rituximab
Location: Italy
Open access status: An open access version is available from UCL Discovery
Publisher version: https://www.clinexprheumatol.org/abstract.asp?a=13...
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: rituximab, B cell depletion therapy, failure, systemic erythematosus lupus
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
URI: https://discovery.ucl.ac.uk/id/eprint/10077886
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