Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study

Off-label use of rituximab is commonly requested for patients with resistant nephropathies. The outcomes and tolerability of rituximab in adult patients with nephropathy treated at our hospital (from 2013 to 2018) were described. Data were retrieved from electronic medical records. Response was clas...

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Autores principales:	Carla Sans-Pola, Antònia Agustí, Josep Àngel Bosch, Irene Agraz, Carmen Alerany, Immaculada Danés
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	rituximab off-label glomerulonephritis nephropathy clinical pharmacology Medicine R
Acceso en línea:	https://doaj.org/article/a89db538800e487f9e571e903aa07532
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spelling	oai:doaj.org-article:a89db538800e487f9e571e903aa075322021-11-11T17:34:40ZOff-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study10.3390/jcm102149412077-0383https://doaj.org/article/a89db538800e487f9e571e903aa075322021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/4941https://doaj.org/toc/2077-0383Off-label use of rituximab is commonly requested for patients with resistant nephropathies. The outcomes and tolerability of rituximab in adult patients with nephropathy treated at our hospital (from 2013 to 2018) were described. Data were retrieved from electronic medical records. Response was classified as complete remission (CR), partial remission (PR), or no response (NR) according to the KDIGO criteria. A total of 89 requests were received for 61 patients. Median age was 58 years (45.9% female). Idiopathic membranous nephropathy (MN) (<i>n</i> = 30) was the most frequent indication, followed by minimal change disease (MCD) (<i>n</i> = 15) and secondary membranoproliferative glomerulonephritis (MPGN) (<i>n</i> = 12). Three patients with focal segmental glomerulosclerosis (FSGS) were included. After most treatment cycles in MN, a CR or PR was observed; median proteinuria levels significantly decreased for these patients (6000 mg/24h (IQR 3584–10,300) vs. 1468.8 (IQR 500–4604.25), <i>p</i> < 0.01). In MPGN, no response was documented after 46.7% of rituximab cycles. A CR or PR was described with the majority of rituximab cycles in MCD, with a significant decrease in proteinuria (6000 mg/24 h (IQR 4007–11,426) vs. 196.8 (IQR 100–1300), <i>p</i> = 0.013). No cycles produced a response in FSGS. Mean CD19+ B-cell decreased in all types of nephropathy (10.44% vs. 0.29%, <i>p</i> < 0.0001). Eleven patients presented infusion-related reactions, and 17 presented infectious complications. The majority of patients with MN and MCD had complete or partial responses; however, neither MPGN nor FSGS had encouraging results.Carla Sans-PolaAntònia AgustíJosep Àngel BoschIrene AgrazCarmen AleranyImmaculada DanésMDPI AGarticlerituximaboff-labelglomerulonephritisnephropathyclinical pharmacologyMedicineRENJournal of Clinical Medicine, Vol 10, Iss 4941, p 4941 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rituximab off-label glomerulonephritis nephropathy clinical pharmacology Medicine R
spellingShingle	rituximab off-label glomerulonephritis nephropathy clinical pharmacology Medicine R Carla Sans-Pola Antònia Agustí Josep Àngel Bosch Irene Agraz Carmen Alerany Immaculada Danés Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study
description	Off-label use of rituximab is commonly requested for patients with resistant nephropathies. The outcomes and tolerability of rituximab in adult patients with nephropathy treated at our hospital (from 2013 to 2018) were described. Data were retrieved from electronic medical records. Response was classified as complete remission (CR), partial remission (PR), or no response (NR) according to the KDIGO criteria. A total of 89 requests were received for 61 patients. Median age was 58 years (45.9% female). Idiopathic membranous nephropathy (MN) (<i>n</i> = 30) was the most frequent indication, followed by minimal change disease (MCD) (<i>n</i> = 15) and secondary membranoproliferative glomerulonephritis (MPGN) (<i>n</i> = 12). Three patients with focal segmental glomerulosclerosis (FSGS) were included. After most treatment cycles in MN, a CR or PR was observed; median proteinuria levels significantly decreased for these patients (6000 mg/24h (IQR 3584–10,300) vs. 1468.8 (IQR 500–4604.25), <i>p</i> < 0.01). In MPGN, no response was documented after 46.7% of rituximab cycles. A CR or PR was described with the majority of rituximab cycles in MCD, with a significant decrease in proteinuria (6000 mg/24 h (IQR 4007–11,426) vs. 196.8 (IQR 100–1300), <i>p</i> = 0.013). No cycles produced a response in FSGS. Mean CD19+ B-cell decreased in all types of nephropathy (10.44% vs. 0.29%, <i>p</i> < 0.0001). Eleven patients presented infusion-related reactions, and 17 presented infectious complications. The majority of patients with MN and MCD had complete or partial responses; however, neither MPGN nor FSGS had encouraging results.
format	article
author	Carla Sans-Pola Antònia Agustí Josep Àngel Bosch Irene Agraz Carmen Alerany Immaculada Danés
author_facet	Carla Sans-Pola Antònia Agustí Josep Àngel Bosch Irene Agraz Carmen Alerany Immaculada Danés
author_sort	Carla Sans-Pola
title	Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study
title_short	Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study
title_full	Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study
title_fullStr	Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study
title_full_unstemmed	Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study
title_sort	off-label use of rituximab in patients with different types of nephropathies in a tertiary hospital: a retrospective study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a89db538800e487f9e571e903aa07532
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Off-Label Use of Rituximab in Patients with Different Types of Nephropathies in a Tertiary Hospital: A Retrospective Study

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