Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: Experience from a national registry (GRAID)
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Contributors
- University of Würzburg
- Department of Dermatology, Allergy and Venereology
- Ludwig Maximilian University of Munich
- University Hospital Tübingen
- Jüdisches Krankenhaus Berlin
- Municipal Hospital Dresden
- Hannover Medical School (MHH)
- Heinrich Heine University Düsseldorf
- University of Cologne
- St. Josef Krankenhaus Essen-Werden
- University Hospital Augsburg
- Universitätsklinikum Schleswig-Holstein - Campus Lübeck
- Kerckhoff Clinic
- ACURA-Rheumazentrum Baden-Baden
- Ambulantes Rheumazentrum
- Friedrich-Alexander University Erlangen-Nürnberg
- University Hospital Frankfurt
- University of Göttingen
- Gemeinschaftspraxis für Strahlentherapie und Radioonkologie
- Rheumapraxis Hofheim
- Klinikum Ludwigshafen
- University Medical Center Mainz
- University of Marburg
- Ruhr University Bochum
- Medical Center Bethel
- Fachklinik 360° - Die Klinik für Orthopädie und Rheumatologie
- University of Regensburg
- Hospital Barmherzige Brüder Regensburg
- University of Rostock
- Praxis für Allgemeinmedizin
- Marien Hospital Stuttgart
- Analytica International
Abstract
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 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).Conclusions: Data from this registry indicate that rituximab is a commonly employed, well-tolerated therapy with potential beneficial effects in standard of care-refractory autoimmune diseases, and support the results from other open-label, uncontrolled studies.
Details
Original language | English |
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Article number | R75 |
Journal | Arthritis Research and Therapy |
Volume | 13 |
Issue number | 3 |
Publication status | Published - 13 May 2011 |
Peer-reviewed | Yes |
External IDs
PubMed | 21569519 |
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