Low immunoglobulin levels increase the risk of severe hypogammaglobulinemia in granulomatosis with polyangiitis patients receiving rituximab

详细信息    查看全文

• 作者：Emilio Besada
• 关键词：ANCA ; associated vasculitis ; Rituximab ; Induction ; Maintenance ; Immunoglobulin ; Hypogammaglobulinemia ; Discontinuation ; Adverse event ; Principal component analysis ; Correspondence analysis
• 刊名：BMC Musculoskeletal Disorders
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：17
• 期：1
• 全文大小：556 KB
• 参考文献：1.Fauci AS, Wolff SM. Wegener’s granulomatosis: studies in eighteen patients and a review of the literature. Medicine. 1973;52:535–61.PubMed CrossRef
  2.Leandro MJ, de la Torre I. Translational mini-review series on B cell directed therapies: the pathogenic role of B cells in autoantibody-associated autoimmune diseases – lessons from B cell-depletion therapy. Clin Exp Immunol 2009:doi:10.​1111/​j.​1365-2249.​2009.​03977.​x
  3.Jones RB, Cohen Tervaert JW, Hauser T, Luqmani R, Morgan MD, Peh CA, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med. 2010;363:211–20.PubMed CrossRef
  4.Stone JH, Merkel PA, Spiera R, Seo P, Langford CA, Hoffman GS, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med. 2010;363:221–32.PubMed PubMedCentral CrossRef
  5.Guillevin L, Pagnoux C, Karras A, Khouatra C, Aumaître O, Cohen P, et al. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Engl J Med. 2014;371:1771–80.PubMed CrossRef
  6.Besada E, Koldingsnes W, Nossent JC. Long-term efficacy and safety of pre-emptive maintenance therapy with rituximab in granulomatosis with polyangiitis: results from a single centre. Rheumatology. 2013;52:2041–7.PubMed CrossRef
  7.Alberici F, Smith RM, Jones RB, Roberts DM, Willcocks LC, Chaudhry A et al. Long-term follow-up of patients who received repeat-dose rituximab as maintenance therapy for ANCA-associated vasculitis. Rheumatology 2014; doi:10.​1093/​rheumatology/​keu452 .
  8.Besada E, Koldingsnes W, Nossent JC. Serum immunoglobulin levels and risk factors for hypogammaglobulinemia during long-term maintenance therapy with rituximab in patients with granulomatosis with polyangiitis. Rheumatology. 2014;53:1818–24.PubMed CrossRef
  9.Venhoff N, Effelsberg NM, Salzer U, Warnatz K, Peter HH, Lebrecht D et al. Impact of rituximab on immunoglobulin concentrations and B cell numbers after cyclophosphamide treatment in patients with ANCA-associated vasculitides. Plos ONE 7(5):e37626. doi:10.1371/journal.pone.0037626.
  10.Eriksson P. Nine patients with anti-neutrophil cytoplasmic antibody-positive vasculitis successfully treated with rituximab. J Intern Med. 2005;257:540–8.PubMed CrossRef
  11.Keogh KA, Ytterberg SR, Fervenza FC, Carlsson KA, Schroeder DR, Specks U. Rituximab for refractory Wegener’s granulomatosis: report of a prospective, open-label pilot trial. Am J Respir Crit Care Med. 2006;173:180–7.PubMed PubMedCentral CrossRef
  12.Jones RB, Ferraro AJ, Chaudhry AN, Brogan P, Salama AD, Smith KG, et al. A multicenter survey of rituximab therapy for refractory antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum. 2009;60:2156–68.PubMed CrossRef
  13.Rhee EP, Laliberte KA, Niles JL. Rituximab as maintenance therapy for anti-neutrophil cytoplasmic antibody –associated vasculitis. Clin J Am Soc Nephrol. 2010;5:1394–400.PubMed PubMedCentral CrossRef
  14.Holle JU, Dubrau C, Herlyn K, Heller M, Ambrosch P, Noelle B, et al. Rituximab for refractory granulomatosis with polyangiitis (Wegener’s granulomatosis): comparison of efficacy in granulomatous versus vasculitic manifestations. Ann Rheum Dis. 2012;71:327–33.PubMed CrossRef
  15.Pullerits R, Ljevak M, Vikgren J, Bokarewa M. Off-trial evaluation of the B-cell targeting treatment in the refractory cases of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis: long-term follow-up from a single centre. Scand J Immunol. 2012;76:411–20.PubMed CrossRef
  16.Wendt M, Gunnarsson I, Bratt J, Bruchfeld A. Rituximab in relapsing or refractory ANCA-associated vasculitis: a case series of 16 patients. Scand J Rheumatol. 2012;41:116–9.PubMed CrossRef
  17.Turner-Stokes T, Sandhu E, Pepper RJ, Stolagiewicz NE, Ashley C, Dinneen D, et al. Induction treatment of ANCA-associated vasculitis with a single dose of rituximab. Rheumatology. 2014;53:1395–403.PubMed CrossRef
  18.Moog P, Probst M, Kuechle C, Hauser C, Heemann U, Thuermel K. Single-dose rituximab for remission induction and maintenance therapy in ANCA-associated vasculitis: a retrospective analysis of 17 patients. Scand J Rheumatol. 2014;43:519–23.PubMed CrossRef
  19.Azar L, Springer J, Langford CA, Hoffman GS. Rituximab with or without a conventional maintenance agent in the treatment of relapsing granulomatosis with polyangiitis (Wegener’s). Arthritis Rheum. 2014;66:2862–70.CrossRef
  20.Taylor S, Salama AD, Joshi L, Pusey CD, Lightman SL. Rituximab is effective in the treatment of refractory ophthalmic Wegener’s granulomatosis. Arthritis Rheum. 2009;60:1540–7.PubMed CrossRef
  21.Roccatello D, Sciascia S, Rossi D, Alpa M, Naretto C, Russo A, et al. Long-term effects of rituximab added to cyclophosphamide in refractory patients with vasculitis. Am J Nephrol. 2011;34:175–80.PubMed CrossRef
  22.Mansfield N, Hamour S, Habib AM, Tarzi R, Levy J, Griffith M, et al. Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated vasculitis. Nephrol Dial Transplant. 2011;26:3280–6.PubMed CrossRef
  23.Roll P, Ostermeier E, Haubitz M, Lovric S, Unger L, Holle J, et al. Efficacy and safety of rituximab treatment in patients with antineutrophil cytoplasmic antibody-associated vasculitides: results from a German registry (GRAID). J Rheumatol. 2012;39:2153–6.PubMed CrossRef
  24.Venhoff N, Niessen L, Kreuzaler M, Rolink AG, Hässler F, Rizzi M, et al. Reconstitution of the peripheral B lymphocyte compartment in patients with ANCA-associated vasculitides treated with rituximab for relapsing or refractory disease. Autoimmunity. 2014;47:401–8.PubMed CrossRef
  25.Rees F, Yazdani R, Lanyon P. Long-term follow-up of different refractory systemic vasculitides treated with rituximab. Clin Rheumatol. 2011;30:1241–5.PubMed CrossRef
  26.Roubaud-Baudron C, Pagnoux C, Meaux-Ruault N, Grasland A, Zoulim A, Le Guen J, et al. Rituximab maintenance therapy for granulomatosis with polyangiitis and microscopic polyangiitis. J Rheumatol. 2012;39:125–30.PubMed CrossRef
  27.Smith RM, Jones RB, Guerry MJ, Laurino S, Catapano F, Chaudhry A, et al. Rituximab for remission maintenance in relapsing antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum. 2012;64:3760–9.PubMed CrossRef
  28.Cartin-Ceba R, Golbin JM, Keogh KA, Peikert T, Sanchez-Menendez M, Ytterberg SR, et al. Rituximab for remission induction and maintenance in refractory granulomatosis with polyangiitis (Wegener’s). Arthritis Rheum. 2012;64:3770–8.PubMed CrossRef
  29.Pendergraft III WF, Cortazar FB, Wenger J, Murphy AP, Rhee EP, Laliberte KA, et al. Long-term maintenance therapy using rituximab-induced continuous B-cell depletion in patients with ANCA vasculitis. Clin J Am Soc Nephrol. 2014;9:736–44.PubMed PubMedCentral CrossRef
  30.Calich AL, Puéchal X, Pugnet G, London J, Terrier B. Charles P et al. Rituximab for induction and maintenance therapy in granulomatosis with polyangiitis (Wegener’s). Results of a single-center cohort study on 66 patients. J Autoimmun. 2014;50:135–41.
  31.Knight A, Hallenberg H, Baecklund E. Efficacy and safety of rituximab as maintenance therapy for relapsing granulomatosis with polyangiitis — a case series. Clin Rheumatol. 2014;33:841–8.PubMed PubMedCentral CrossRef
  32.Charles P, Néel A, Tieulié N, Hot A, Pugnet G, Decaux O, et al. Rituximab for induction and maintenance of ANCA associated vasculitides: a multicenter retrospective study on 80 patients. Rheumatology. 2014;53:532–9.PubMed CrossRef
  33.Roberts DM, Jones RB, Smith RM, Alberici F, Kumaratne DS, Burns S, et al. Rituximab-associated hypogammaglobulinemia: Incidence, predictors ad outcomes in patients with multi-system autoimmune disease. J Autoimmun. 2015;57:60–5.PubMed CrossRef
  
• 作者单位：Emilio Besada (1)
  
  1. Bone and Joint Research Group, Institute of Clinical Medicine, UiT The Arctic University of Norway, 9037, Tromsø, Norway
  
• 刊物主题：Orthopedics; Rehabilitation; Rheumatology; Sports Medicine; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2474

文摘

Background Randomized controlled trials and retrospective studies in ANCA-associated vasculitis (AAV) concurred that rituximab (RTX) is effective to induce and maintain remission. Infections and hypogammaglobulinemia during RTX were usually infrequent and uncomplicated. But in the Tromsø study cohort, 45 % of patients with granulomatosis with polyangiitis (GPA) developed hypogammaglobulinemia during RTX maintenance leading to its discontinuation in 62 %.