Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab

Year 2024, , 268 - 273, 30.10.2024

Sultan Gözde Temiz , Dilek Barutcu Atas , Fatma Alibaz Öner , Arzu Velioglu , İzzet Hakkı Arıkan , Serhan Tuğlular , Haner Direskeneli , Ebru Aşıcıoğlu

https://doi.org/10.5472/marumj.1572912

Abstract

Objective: Patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and systemic lupus erythematosus (SLE) are
prone to infections. This study aims to clarify infectious complications in terms of both the disease and the specific treatments used.
Patients and Methods: Sixty-three patients with SLE and AAV with kidney involvement treated with rituximab or cyclophosphamide
were included. Patients were examined regarding infections, comorbidities, immunosuppressives, estimated glomerular filtration rate
(eGFR), use of prophylactic antibiotics, hospitalization, and death.
Results: Patients with SLE experienced more genitourinary infections in general (p=0.009). In the rituximab group, SLE patients had a
higher incidence of genitourinary infections, septicemia, and intensive care unit admissions. Furthermore, lupus patients with serious
infections were all treated with rituximab and had a higher incidence of low respiratory tract infections (p=0.003). On the contrary,
treatment with rituximab did not cause an increased risk of infection among AAV patients compared to cyclophosphamide. In general,
patients with serious infections had lower IgG and total Ig levels (p<0.05).
Conclusion: Patients with SLE had a higher risk of genitourinary infections and also a higher risk of sepsis, serious infections, and
hospitalizations when treated with rituximab. Immunoglobulin levels are associated with serious infections.

Keywords

ANCA-associated vasculitis, Immunoglobulin, Infections, Lupus nephritis, Rituximab.

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