Suppr超能文献

简要报告:利妥昔单抗治疗成人 IgA 血管炎(过敏性紫癜)。

Brief Report: Rituximab for the Treatment of Adult-Onset IgA Vasculitis (Henoch-Schönlein).

机构信息

Parma University Hospital, Parma, Italy.

G. Bosco Hospital and University of Turin, Turin, Italy.

出版信息

Arthritis Rheumatol. 2018 Jan;70(1):109-114. doi: 10.1002/art.40339. Epub 2017 Dec 1.

Abstract

OBJECTIVE

Adult-onset IgA vasculitis (Henoch-Schönlein) (IgAV) is a rare systemic vasculitis characterized by IgA1-dominant deposits. The treatment of adult-onset IgAV is controversial and is based on the combination of glucocorticoids and immunosuppressive agents, but many patients have refractory or relapsing disease despite treatment. Rituximab (RTX) is a B cell-depleting antibody of proven efficacy in antineutrophil cytoplasmic antibody-associated vasculitis. We undertook this study to test the efficacy and safety of RTX in a multicenter cohort of patients with adult-onset IgAV.

METHODS

In this multicenter observational study, we included patients with adult-onset IgAV who had received RTX either for refractory/relapsing disease or because they had contraindications to conventional glucocorticoid/immunosuppressive therapy. We analyzed the rates of remission (defined on the basis of the Birmingham Vasculitis Activity Score [BVAS]) and relapse as well as the variations over time in estimated glomerular filtration rate (GFR), proteinuria, C-reactive protein (CRP) level, BVAS, and prednisone dose.

RESULTS

Twenty-two patients were included; their median duration of follow-up was 24 months (interquartile range 18-48 months). Sixteen patients received RTX as add-on therapy and 6 as monotherapy. Twenty patients (90.9%) achieved remission, and 7 of those 20 patients (35%) had subsequent relapse of disease. There were significant reductions in 24-hour proteinuria (P < 0.0001), CRP level (P = 0.0005), BVAS (P < 0.0001), and prednisone dose (P < 0.0001) from RTX initiation through the last follow-up visit; estimated GFR remained stable. RTX was generally well tolerated. One patient died after 60 months of follow-up.

CONCLUSION

Our data suggest that RTX is an effective and safe therapeutic option for adult-onset IgAV.

摘要

目的

成人发病 IgA 血管炎(亨诺克-舍恩莱因)(IgAV)是一种罕见的系统性血管炎,其特征为 IgA1 为主的沉积物。成人发病 IgAV 的治疗存在争议,基于糖皮质激素和免疫抑制剂的联合治疗,但许多患者尽管接受治疗仍存在难治性或复发性疾病。利妥昔单抗(RTX)是一种已被证明在抗中性粒细胞胞质抗体相关性血管炎中有效的 B 细胞耗竭抗体。我们进行这项研究,旨在测试 RTX 在成人发病 IgAV 的多中心队列患者中的疗效和安全性。

方法

在这项多中心观察性研究中,我们纳入了接受 RTX 治疗的成人发病 IgAV 患者,这些患者要么患有难治性/复发性疾病,要么对常规糖皮质激素/免疫抑制治疗有禁忌证。我们分析了缓解率(基于伯明翰血管炎活动评分 [BVAS] 定义)和复发率,以及估计肾小球滤过率(GFR)、蛋白尿、C 反应蛋白(CRP)水平、BVAS 和泼尼松剂量随时间的变化。

结果

共纳入 22 例患者;中位随访时间为 24 个月(四分位距 18-48 个月)。16 例患者接受 RTX 作为附加治疗,6 例患者接受 RTX 作为单药治疗。20 例患者(90.9%)达到缓解,其中 20 例患者中的 7 例(35%)随后发生疾病复发。从 RTX 起始到最后一次随访,24 小时蛋白尿(P < 0.0001)、CRP 水平(P = 0.0005)、BVAS(P < 0.0001)和泼尼松剂量(P < 0.0001)均显著降低;估计 GFR 保持稳定。RTX 总体上耐受性良好。1 例患者在 60 个月随访后死亡。

结论

我们的数据表明,RTX 是成人发病 IgAV 的一种有效且安全的治疗选择。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验