Biopsy-verified response of severe lupus nephritis to treatment with rituximab (anti-CD20 monoclonal antibody) plus cyclophosphamide after biopsy-documented failure to respond to cyclophosphamide alone

被引：74

作者：

van Vollenhoven, RF ^{[1
]}

Gunnarsson, I

Welin-Henriksson, E

Sundelin, B

Österborg, A

Jacobson, SH

Klareskog, L

机构：

[1] Karolinska Hosp, Dept Rheumatol, S-17176 Stockholm, Sweden

[2] Karolinska Hosp, Dept Pathol, S-10401 Stockholm, Sweden

[3] Karolinska Hosp, Dept Haematol, S-10401 Stockholm, Sweden

[4] Karolinska Hosp, Dept Nephrol, S-10401 Stockholm, Sweden

来源：

SCANDINAVIAN JOURNAL OF RHEUMATOLOGY | 2004年 / 33卷 / 06期

关键词：

D O I：

10.1080/03009740410010227

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The monoclonal anti-B cell antibody rituximab (Rituxin, Mabthera) may be of benefit in antibody-driven diseases, including systemic lupus erythematosus (SLE) nephritis. Patients and treatment: Two female patients with biopsy-confirmed severe and active SLE nephritis despite treatment with cyclophosphamide (CyX) were given four rituximab infusions plus two additional CyX infusions. Results: Both patients tolerated the treatment well and SLE activity improved. On repeat kidney biopsy after the combined treatment, Patient 1 showed a profound reduction of nephritis activity, and she was maintained on low-dose prednisolone only. A repeat biopsy after 1 year confirmed the sustained reduction of lupus nephritis activity. In Patient 2, rebiopsy after combined treatment also showed a significant reduction in disease activity. Conclusion: These cases provide histopathological documentation of a significant treatment benefit from rituximab plus CyX in two patients refractory to CyX alone. This combination is being explored further as salvage therapy for such CyX-resistant patients.

引用

页码：423 / 427

页数：5

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