Remission of refractory lupus nephritis with a protocol including rituximab
| Autor: | E Bartoli, G C Avanzi, G P Fra |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Lupus nephritis Antineoplastic Agents 030204 cardiovascular system & hematology Gastroenterology Antibodies Monoclonal Murine-Derived 03 medical and health sciences 0302 clinical medicine Rheumatology Prednisone Internal medicine medicine Humans Glucocorticoids 030203 arthritis & rheumatology business.industry Remission Induction Antibodies Monoclonal Immunosuppression medicine.disease Lupus Nephritis Proteinuria Immunology Monoclonal Drug Therapy Combination Female Rituximab Methotrexate business Nephrotic syndrome Immunosuppressive Agents medicine.drug |
| Zdroj: | Lupus. 12:783-787 |
| ISSN: | 1477-0962 0961-2033 |
| DOI: | 10.1191/0961203303lu453cr |
| Popis: | Immunosuppression with corticosteroids and cyclophosphamide is the standard of care for lupus nephritis. We report a 19-year old woman with lupus nephritis and nephrotic syndrome who had not achieved complete remission after treatment with 15.7g cyclophosphamideand 13.7g prednisone.We planned a consolidation phase with: 1) cyclophosphamide 20mg/kg i.v. every 28 days for three cycles; 2) anti-CD20 chimeric monoclonal antibody (rituximab) 375mg/m2i.v. weekly for four weeks; and 3) slow tapering of prednisone p.o., q.o.d., after a reinduction dose during rituximab administration. At the end of this phase the patient achieved complete remission. An indefinite maintenance treatment with methotrexate, cyclosporin and low-dose prednisone was then started. Twenty-four months later the patient remains in remission. In the immunosuppressive treatment of lupusnephritisthe insertionof a consolidationphasewith rituximab combinedwith cyclophosphamide achieves a therapeutically important and lasting deletion of the lymphocyte clone responsible for autoimmunity. |
| Databáze: | OpenAIRE |
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