Pharmacodynamics of rituximab in paediatric immune mediated diseases: B cell depletion and repopulation, effects on immunoglobulin levels and risk for infections
Authors' conclusion
Time to B cell repopulation post-RTX ranged individually but did not significantly differ between paediatric patient groups. Severe infections were non-frequent and not associated with low (post-RTX) IgG levels.
Study context
- Population
- Children with immune-mediated diseases (autoimmune diseases (AID), immune dysregulation (ID), haematological diseases (HD), renal diseases (RD)) who received rituximab (RTX) at one centre
- Participants
- 52 children
- Exposure
- AID vs ID vs HD vs RD
- AIDn = 9
- IDn = 6
- HDn = 7
- RDn = 7
- Outcome
- Time to B cell repopulation after RTX (B cell depletion: B cells <10 cells/μl)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Time to B cell repopulation (30/45 patients with repopulation)
- Overall median time to repopulation, days (IQR 140-224)
- 166
Observational data: associations, not effects.
Further findings
Post-RTX B cell depletion
- Patients with B cell depletion
- 45/49
Low IgG for age at least once after RTX
- Patients with low IgG
- 13/52 (25%)
- Infection during low IgG
- 11/13
- Severe infection during low IgG
- 2/13
- Low IgG vs severe infection association
- P = 0.459
Safety
Events
| Outcome | ID | HD | RD |
|---|---|---|---|
| Severe infections leading to hospitalisation | 3 | 1 | 3 |
- Severe infections leading to hospitalisation — Overall
- 7/52 (13.5%)
Original publication
Pharmacodynamics of rituximab in paediatric immune mediated diseases: B cell depletion and repopulation, effects on immunoglobulin levels and risk for infections. Clin Exp Rheumatol. Published 5 January 2023. doi:10.
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