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Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID)

Please always quote using this URN: urn:nbn:de:bvb:20-opus-142856
  • Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin’s lymphoma in a real-life clinical setting. Methods: Patients who received rituximab havingIntroduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin’s lymphoma in a real-life clinical setting. Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators. Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician’s visual analogue scale; mean improvement from baseline of 12.1 mm)show moreshow less

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Author: Hans-Peter Tony, Gerd Burmester, Hendrik Schulze-Koops, Mathias Grunke, Joerg Henes, Ina Kötter, Judith Haas, Leonore Unger, Svjetlana Lovric, Marion Haubitz, Rebecca Fischer-Betz, Gamal Chehab, Andrea Rubbert-Roth, Christof Specker, Jutta Weinerth, Julia Holle, Ulf Müller-Ladner, Ramona König, Christoph Fiehn, Philip Burgwinkel, Klemens Budde, Helmut Sörensen, Michael Meurer, Martin Aringer, Bernd Kieseier, Cornelia Erfurt-Berge, Michael Sticherling, Roland Veelken, Ulf Ziemann, Frank Strutz, Praxis von Wussow, Florian MP Meier, Nico Hunzelmann, Enno Schmidt, Raoul Bergner, Andreas Schwarting, Rüdiger Eming, Michael Schwarz-Eywill, Siegfried Wassenberg, Martin Fleck, Claudia Metzler, Uwe Zettl, Jens Westphal, Stefan Heitmann, Anna L. Herzog, Heinz Wiendl, Waltraud Jakob, Elvira Schmidt, Klaus Freivogel, Thomas Dörner, Michael Hertl, Rudolf Stadler
URN:urn:nbn:de:bvb:20-opus-142856
Document Type:Journal article
Faculties:Medizinische Fakultät / Neurologische Klinik und Poliklinik
Medizinische Fakultät / Medizinische Klinik und Poliklinik II
Language:English
Parent Title (English):Arthritis Research & Therapy
Year of Completion:2011
Volume:13
Issue:R75
Pagenumber:1-14
Source:Arthritis Research & Therapy 2011 13:R75.
DOI:https://doi.org/10.1186/ar3337
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:GRAID
Release Date:2019/02/11
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung