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• W4379648454 abstract "Background Lupus nephritis(LN) can be a cause of morbidity and mortality in a significant portion of patients. The treatment of lupus nephritis can be challenging in some patients who are resistant to conventional immunosuppressive treatment. Objectives Rituximab is a promising agent for treating resistant LN patients. We evaluated the response of LN patients who were treated with rituximab treatment in our clinic retrospectively. Methods We evaluated LN patients who were followed and treated with at least one course of rituximab in our clinic between 2010-2022. LN was confirmed by renal biopsy. Creatinine clearence, serum creatinine, 24- hour proteinuria and Systemic Lupus Erythematosus- Disease Activity Index- 2000 (SLE-DAI-2K) were analyzed before and after Rituximab treatment. Primary end point was current prednisolone dose ≤5 mg and 24-hour proteinuria ≤ 500mg. Also, we evaluated the side effect of rituximab. Results Forty seven patients (34 F, 13 M) were treated with rituximab. All patients had active lupus nephritis at initiation. Mean of disease duration was 10.44 ± 6.9 years. All patients were initally treated with high dose steroids. The other medications, the patients were previously treated with, were cyclophosphamide (n= 35), mycophenolate mofetil (n= 31), azathioprine (n= 6), cyclosporine (n= 2). Patients received an average of 4.1 ± 3.68 courses of rituximab (Table 1). The median value of pre-treatment proteinuria was 3050 (1370, 5175) mg/day. The median value of proteinuria after the final course was 747 (396, 1500) mg/day (p< 0.01). Serum creatinine level was changed from 0.94 ± 0.59 to 0.98 ± 0.68 (p= 0.53). Mean serum creatinine clearence was increased from 102.01 ± 43.2 to 109.1 ± 51.3 (p=0.28). Mean SLE-DAI-2K was reduced from 16.3 ± 6.2 to 7.2 ± 4.8 (p< 0.01). While initial steroid dose was 24.13 ± 18.47 mg/day, steroid dose at last rituximab course was 7.5 ± 5.8 mg/day (p< 0.01). End stage renal disease was developed in 3 (%6) patients. For primary end point of view, currrent prednisolone dose ≤ 5mg and 24-hour proteinuria ≤ 500 mg were achieved in %53.1, %36.1 of patients respectively. Both criteria was met by %25.5 of patients. During the treatment, 2 patients had serum reaction, 3 had pneumonia, 3 had herpes zoster. Three patients had hippogamaglobulinemia and treated with intravenous immunoglobulin. No one was died of lupus nephritis. Conclusion In lupus nephritis patients resistant to conventional therapy, rituximab can be tried as an alternative treatment choice. In our single center, most of the patients were class IV nephritis whom we observed the efficacy of rituximab. Generally, the side effects were acceptable. Rituximab could be a good option as a steroid reducing agent and exhibit a favorable clinical response in these patients. Table 1. Characteristics of patients Age, mean ± SD years 42.3 ± 11.1 Gender, n (%) Female Male 34 (64.2) 13 (24.5) Disease duration, mean ± SD, years 10.44 ± 6.9 *ISN/RPS Classification, n (%) Class II Class III Class IV Class V Class III+V Class IV+V 5 (10.6) 7 (14.8) 16 (34) 6 (12.7) 7 (14.8) 6 (12.7) RTX treatment courses mean ± SD 4.1 ± 3.68 Previous treatments, n Cyclophosphamide Mycophenolate mofetil Azathioprine Cyclosporine 35 31 6 2 *ISN/RPS Classification: International Society of Nephrology/Renal Pathology Society Classification REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests None Declared." @default.
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• W4379648454 date "2023-05-30" @default.
• W4379648454 modified "2023-10-01" @default.
• W4379648454 title "AB0537 RITUXIMAB THERAPY IN LUPUS NEPHRITIS RESISTANT TO CONVENTIONAL THERAPY – A SINGLE CENTER EXPERIENCE (CASE SERIES)" @default.
• W4379648454 doi "https://doi.org/10.1136/annrheumdis-2023-eular.5000" @default.
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