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Kidney Week

Abstract: SA-PO701

The Irish Rituximab Study (IRiS): A Nationwide Study of Rituximab Prescribing and Effectiveness for the Treatment of Kidney Diseases

Session Information

Category: Glomerular Diseases

  • 1303 Glomerular Diseases: Clinical‚ Outcomes‚ and Trials

Authors

  • Kelly, Dearbhla M., Beaumont Hospital, Dublin, Ireland
  • Ni Cathain, Dearbhail, Beaumont Hospital, Dublin, Ireland
  • O'Connell, Blathnaid, University Hospital Waterford, Waterford, Waterford, Ireland
  • O'Hanlon, James, Beaumont Hospital, Dublin, Ireland
  • Hanahoe, Aislinn Ellen, Tallaght University Hospital, Dublin, Dublin, Ireland
  • O'Brien, Sorcha, St. James's Hospital, Dublin, Ireland
  • Ahmed, Omer, University Hospital Limerick, Dooradoyle, Limerick, Ireland
  • Piggott, Raymond Simon, Mater Misericordiae University Hospital, Dublin, Ireland
  • Slattery, Laura M., Beaumont Hospital, Dublin, Ireland
  • White, Eoghan, Cork University Hospital, Cork, Cork, Ireland
  • Brown, Catherine M., University Hospital Waterford, Waterford, Waterford, Ireland
  • Casserly, Liam F., University Hospital Limerick, Dooradoyle, Limerick, Ireland
  • Hudson, Amy, Beaumont Hospital, Dublin, Ireland
  • Little, Mark Alan, Tallaght University Hospital, Dublin, Dublin, Ireland
  • Sadlier, Denise M., Mater Misericordiae University Hospital, Dublin, Ireland
  • Sexton, Donal J., St. James's Hospital, Dublin, Ireland
  • Moran, Sarah Margaret, Cork University Hospital, Cork, Cork, Ireland
  • O'Shaughnessy, Michelle M., Cork University Hospital, Cork, Cork, Ireland
  • Conlon, Peter J., Beaumont Hospital, Dublin, Ireland

Group or Team Name

  • IRish Rituximab Study (IRiS)
Background

Rituximab is increasingly used to treat glomerular diseases, including ANCA-associated vasculitis (AAV), membranous nephropathy, minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS). However, strong evidence supporting its use in some of these conditions is lacking and it is also costly and potentially toxic. Using nationwide data, we examined prescribing practices and clinical outcomes in Irish patients who received Rituximab for glomerular disease.

Methods

All patients attending Irish Nephrology Centres who received Rituximab for glomerular disease between 01/01/13 and 31/12/21 were included in this retrospective observational study. Rituximab dosing, prior and concurrent medications, clinical presentation, and outcomes were extracted from electronic healthcare records. The primary efficacy outcome was complete or partial remission at 12 months. Descriptive statistics are herein presented.

Results

From 9 participating centres, we identified 405 patients (median age 55.3 years; 37.3% female), a majority (53%) of whom had AAV, Table. The most frequent Rituximab dose was 1g (60%) and the median cumulative dose received was 3g (IQR 2-4g). From patients with available outcome data (n=306), 259 (85%) achieved CR or PR by a median of 5 (IQR 2-10) months. During a median follow-up of 49 (IQR 31-74) months, 71 (23%) patients had disease relapses and 80 (25%) experienced adverse events: 72 (22%) infections, 40 (13%) leucopenia, 18 (9%) infusion reactions, 15 (7%) malignancies, and 12 (3%) episodes of hypogammaglobuinemia.

Conclusion

Based on preliminary data, Rituximab was an effective and safe treatment in the majority of Irish adults with glomerular disease who received it.