Rituximab as an effective add-on maintenance therapy for disease activities in childhood-onset systemic lupus erythematosus
Authors' conclusion
This study provides real-world data and illuminates rituximab's role in maintaining disease stability among patients with paediatric-onset SLE who are serologically active without major clinical deterioration.
Study context
- Population
- Paediatric patients diagnosed with systemic lupus erythematosus (SLE) at the National Taiwan University Hospital, January 1992–August 2022 (median age 14.3 years at diagnosis)
- Participants
- 40 vs 53
- Exposure
- RTX add-on maintenance therapy vs contemporary comparison group
- Rituximabn = 40
- Comparisonn = 53reference
- Outcome
- Disease activity, serology, GC dose, disease control and flares in RTX-treated cohort
Methodological detailssingle-centre, contemporary matched comparison group
- Single-centre
- Contemporary matched comparison group
Main finding
As reported in the abstract
Median SLEDAI-2K before RTX
8
Median SLEDAI-2K after 2 years
4
Patients achieving disease control
8
20%
Patients with no flare-ups during follow-up (median, 2 years)
35
87.5%
Observational data: associations, not effects.
Further findings
SLEDAI-2K, median score (before rituximab vs after 2 years)
- Median SLEDAI-2K decreased from 8 before rituximab administration to 4 after 2 years
- Rituximab-treated cohort
Mortality and end-stage renal disease
- No mortality or development of end-stage renal disease observed in the rituximab-treated cohort
C3, C4 and anti-double stranded DNA (anti-dsDNA) levels · 6 months
- C3 and C4 increased and anti-dsDNA decreased significantly within 6 months
Equivalent oral prednisolone dose · 6 months
- Equivalent oral prednisolone dose halved after 6 months
Rituximab-treated cohort vs comparison group
- Rituximab-treated cohort exhibited superior disease outcomes and a reduced incidence of flare-ups vs comparison group (n=53)
Safety
Hypogammaglobulinaemia requiring intravenous immunoglobulin (IVIG) replacement
- Only one rituximab-treated patient developed hypogammaglobulinaemia that required IVIG replacement
- 1
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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