Clinical Epidemiology and Ageing

Efficacy and safety of rituximab for systemic lupus erythematosus-associated immune cytopenias: A multicenter retrospective cohort study of 71 adults.

Serris A, Amoura Z, Canoui-Poitrine F, Terrier B, Hachulla E, Costedoat-Chalumeau N, Papo T, Lambotte O, Saadoun D, Hié M, Blanche P, Lioger B, Gottenberg J-E, Godeau B, Michel M Am J Hematol. 2018;93(3):424-429.

<p>The aim of the study was to assess the efficacy and safety of rituximab (RTX) for treating systemic lupus erythematosus (SLE)-associated immune cytopenias. This multicenter retrospective cohort study of adults from French referral centers and networks for adult immune cytopenias and SLE involved patients ≥18 years old with a definite diagnosis of SLE treated with RTX specifically for SLE-associated immune cytopenia from 2005 to 2015. Response assessment was based on standard definitions. In total, 71 patients, 61 women (85.9%), with median age 36 years [interquartile range 31-48], were included. The median duration of SLE at the time of the first RTX administration was 6.1 years [2.6-11.6] and the reason for using RTX was immune thrombocytopenia (ITP) for 44 patients (62.0%), autoimmune hemolytic anemia (AIHA) for 16 (22.5%), Evans syndrome for 10 (14.1%), and pure red cell aplasia for one patient. Before receiving RTX, patients had received a mean of 3.1 ± 1.3 treatments that included corticosteroids (100%), and hydroxychloroquine (88.5%). The overall initial response rate to RTX was 86% (91% with ITP, 87.5% with AIHA, and 60% with Evans syndrome), including 60.5% with complete response. Median follow-up after the first injection of RTX was 26.4 months [14.3-71.2]. Among 61 initial responders, relapse occurred in 24 (39.3%); for 18, RTX retreatment was successful in 16 (88.8%). Severe infections occurred after RTX in three patients, with no fatal outcome. No cases of RTX-induced neutropenia were observed. In conclusion, RTX seems effective and relatively safe for treating SLE-associated immune cytopenias.</p>

MeSH terms: Adult; Anemia, Hemolytic, Autoimmune; Disease Susceptibility; Disease-Free Survival; Drug Evaluation; Drug Therapy, Combination; Female; Fever; Follow-Up Studies; Humans; Immunosuppressive Agents; Infections; Kaplan-Meier Estimate; Lupus Erythematosus, Systemic; Male; Middle Aged; Purpura, Thrombocytopenic, Idiopathic; Red-Cell Aplasia, Pure; Retrospective Studies; Rituximab; Thrombocytopenia; Treatment Outcome
DOI: 10.1002/ajh.24999