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Abstract: PO1914

Rituximab as Maintenance Therapy in Lupus Nephritis

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Jeyabalan, Anushya, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Rosenthal, Jillian, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Zonozi, Reza, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Huizenga, Noah, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Laliberte, Karen A., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Niles, John, Massachusetts General Hospital, Boston, Massachusetts, United States
Background

Rituximab (RTX) has been shown to be effective in refractory lupus nephritis (LN) in some studies. Minimal literature exists on using RTX as maintenance therapy for LN.

Methods

We performed a retrospective review of 21 patients (pts) with biopsy-proven LN who received RTX. We analyzed clinical data at baseline (pre-RTX) and up to 36 months (mo) of follow-up.

Results

Of 21 pts, 7 received RTX as part of first-line treatment, 7 for refractory LN and 7 for relapsing LN. All continued RTX (1gm q4-6 mo) as maintenance therapy. 15/21 (71%) pts were on RTX monotherapy (excluding prednisone and plaquenil) at 12 mo, 14/16 (88%) at 24 mo, and 11/13 (85%) at 36 mo. 17/19 (89%) had continuous B cell depletion at 12 mo, 13/14 (93%) at 24 mo, and 11/12 (92%) at 36 mo. At 12 mo, 16/21 (76%) achieved complete or partial remission. Median UPCR (g/g) decreased from 2.95 at baseline to 0.61 at 12 mo, 0.42 at 24 mo and 0.21 at 36 mo. 16/21 (76%) pts were on prednisone ≤5mg/day at 12 mo, 13/16 (81%) at 24 mo, and 10/13 (77%) at 36 mo. Over 36 mo, 2 pts had LN relapses while on RTX alone, and later progressed to ESRD. 2 pts developed hypogammaglobulinemia.

Conclusion

RTX monotherapy appears promising as maintenance therapy in LN. Given favorable renal outcomes and steroid-sparing effect, larger studies studying this effect may be warranted.

Results