| Rituximab and mycophenolate mofetil for relapsing proliferative lupus nephritis: a long-term prospective study. | |
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MedLine Citation:
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PMID: 19179411 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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/m(2)), 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. |
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Authors:
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John N Boletis; Smaragde Marinaki; Chryssanthe Skalioti; Sofia S Lionaki; Aliki Iniotaki; Petros P Sfikakis |
Publication Detail:
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Type: Journal Article Date: 2009-01-29 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 24 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-22 Completed Date: 2009-08-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
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Languages: eng Pagination: 2157-60 Citation Subset: IM |
Affiliation:
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Nephrology Department, Laikon Hospital, Athens, Greece. laikneph@laiko.gr |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Antibodies, Monoclonal / therapeutic use* Drug Therapy, Combination Female Humans Immunologic Factors / therapeutic use* Immunosuppressive Agents / therapeutic use* Lupus Nephritis / drug therapy*, pathology Mycophenolic Acid / analogs & derivatives*, therapeutic use Prospective Studies Recurrence Time Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunologic Factors; 0/Immunosuppressive Agents; 0/rituximab; 128794-94-5/mycophenolate mofetil; 24280-93-1/Mycophenolic Acid |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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