Rituximab therapy for IgA-vasculitis with nephritis: a case series and review of the literature

Fenoglio, Roberta; Naretto, Carla; Basolo, B; Quattrocchio, Giacomo; Ferro, Michela; Mesiano, Paola; Beltrame, Giulietta; Roccatello, Dario

doi:10.1007/s12026-016-8827-5

Cited by 55 publications

(29 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The average age at time of diagnosis in our review was 22.93 years with a median of 16 years, which is greater than the average age of 6 years described in the bibliography for general patients with IgAV [3]. Most patients treated with RTX are primarily adult [9,10], which may indicate that the population requiring RTX treatment showed a later onset of disease (e.g. greater frequency of renal manifestations in adult patients with IgAV vs. pediatric patients).…”

Section: Discussionmentioning

confidence: 61%

See 1 more Smart Citation

Rituximab treatment for IgA vasculitis: A systematic review

Chamorro

Carbonell

Canelo³

et al. 2019

Preprint

View full text Add to dashboard Cite

Objetives: Immunoglobulin A vasculitis (IgAV) is an inflammatory disease with a controversial treatment based in corticosteroids as first line. To review cases of patients with IgA vasculitis (IgAV) treated with rituximab (RTX) and assess disease characteristics, treatment efficacy and safety.Methods: We conducted a systematic literature review according to PRISMA guidelines. We searched Pubmed, Web of Science, Embase and Scopus, selecting articles with information on IgAV and RTX treatment up to February 2019, with no language limitations. We extracted data on patient characteristics, disease evolution, treatment safety and efficacy. We created a database and analyzed it using statistical software package SPSS v 22.0.Results: We extracted clinical data for 43 IgAV patients treated with RTX. Distribution by sex was similar, and the median age at diagnosis was 16 (range 2 months to 70 years). The majority of patients were diagnosed at a pediatric age (24 patients under 18, 55.81%). The time of disease evolution until RTX administration greatly varied. An important number of patients suffered renal complications (86%) before RTX treatment.The frequency of adverse effects from RTX was low (7%, hypersensitivity with no treatment interruption). In terms of disease evolution, 41 patients (95.3%) presented clinical improvement, 15 patients had recurrence after initial remission (34.9%) and 34 patients (79.1%) achieved full remission after completing treatment. None of the patients treated with RTX and included in our systematic review died.Conclusions: RTX is efficacious in patients with IgAV. A high percentage of patients achieved complete remission with a favorable safety profile.PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

show abstract

Section: Discussionmentioning

confidence: 61%

“…To our knowledge, ours is the first systematic literature review of IgAV vasculitis treatment with RTX in pediatric and adult populations, although we did find a narrative literature review [9] and a retrospective study of IgAV patients treated with rituximab [10].…”

Section: Discussionmentioning

confidence: 90%

Rituximab treatment for IgA vasculitis: A systematic review

Chamorro

Carbonell

Canelo³

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…Moreover, it did not produce a reduction in antibody levels [30]. However, there have been multiple reports of patients achieving excellent responses with significant clinical improvements, including a study following renal transplantation [31][32][33]. The largest study involving adult patients with HSP that we have found was done by Maritati et al and included 22 patients, with a median follow-up time of 24 months [34].…”

Section: Lupus Nephritis and Iga Nephropathy/henoch-schonlein Purpuramentioning

confidence: 99%

Use of Rituximab in Management of Rapidly Progressive Glomerulonephritis

Cancarevic

Malik

2020

Cureus

View full text Add to dashboard Cite

Rapidly progressive glomerulonephritis (RPGN) is a form of glomerulonephritis characterized by loss of renal function within weeks. Although a variety of underlying causes can trigger RPGN, the ultimate pathologic mechanism is the podocyte and epithelial activation leading to the crescent formation. Rituximab has been increasingly and successfully used for autoimmune conditions in recent years. Treatment of RPGN is based on the underlying condition, but specific clinical guidelines are lacking. In this article, we have tried to establish the role of rituximab in the management of patients with RPGN. All the studies we have used were found in the PubMed database, limited to studies involving adults. Animal studies and studies involving the pediatric population were excluded. The currently available literature does not support switching to rituximab as the first-line agent. It has failed to prove consistently superior to other medications. However, combined with other commonly prescribed treatment regimens, namely corticosteroids, with or without cytotoxic drugs, rituximab has shown efficacy in many studies. Therefore, we have concluded that the most prudent use of rituximab in patients with RPGN would be in those with disease refractory to standard management with corticosteroids and cytotoxic drugs or in those who have intolerable side effects. We believe that clinicians should keep reporting any cases of RPGN treated with rituximab so that a more clear pattern emerges and more exact treatment guidelines can be made.

show abstract

“…Moreover, RTX is a valuable option in the treatment of several connective tissue diseases [11,12,13] and immune-meditated glomerular diseases such as idiopathic membranous nephropathy [14,15] and Henoch-Schonlein purpura nephritis [16]. RTX has emerged as an alternative treatment of frequently relapsing, steroid-dependent or steroid-resistant nephrotic syndrome in children [17,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

High-Dose Rituximab Ineffective for Focal Segmental Glomerulosclerosis: A Long-Term Observation Study

Roccatello¹,

Sciascia²,

Rossi³

et al. 2017

Am J Nephrol

Self Cite

View full text Add to dashboard Cite

Background: A beneficial effect of rituximab (RTX) on focal segmental glomerulosclerosis (FSGS) in pediatric patients or in transplant recipients has been reported in isolated cases. However, the use of RTX in adult patients with idiopathic FSGS needs further investigation. Methods: Eight patients who had biopsy-proven FSGS (63.9 ± 14.0, range 40-81 years, 4 women, 4 men) with major risk factors precluding corticosteroids or conventional immunosuppression were treated with a high dose of RTX (8 weekly doses of 375 mg/m²) and prospectively followed up for at least 2 years (29.1 ± 8.8 months, range 24-42 months). Results: RTX failed to improve proteinuria in 7 out of 8 patients, who had persistent nephrotic proteinuria. In one case, a rapidly deteriorating renal function was also observed. Only one patient showed an improvement in renal function and a remarkable reduction in proteinuria. There were no differences in clinical or laboratory characteristics or in the CD20 B lymphocyte count after RTX between the responder and the 7 nonresponder patients. Conclusions: Only a minority (1 of 8) in our series of adult patients with FSGS showed positive effects of high doses of RTX. Future studies are warranted to investigate more promising therapeutic options in the management of FSGS.

show abstract

Rituximab therapy for IgA-vasculitis with nephritis: a case series and review of the literature

Cited by 55 publications

References 53 publications

Rituximab treatment for IgA vasculitis: A systematic review

Rituximab treatment for IgA vasculitis: A systematic review

Use of Rituximab in Management of Rapidly Progressive Glomerulonephritis

High-Dose Rituximab Ineffective for Focal Segmental Glomerulosclerosis: A Long-Term Observation Study

Contact Info

Product

Resources

About