Research Article
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Year 2024, Volume: 37 Issue: 3, 268 - 273, 30.10.2024
https://doi.org/10.5472/marumj.1572912

Abstract

References

  • Robson J, Doll H, Suppiah R, et al. Damage in the ancaassociated vasculitides: long-term data from the European vasculitis study group (EUVAS) therapeutic trials. Ann Rheum Dis 2015; 74: 177-84. 20131115. doi: 10.1136/ annrheumdis-2013-203927.
  • D’Cruz DP, Khamashta MA, Hughes GRV. Systemic lupus erythematosus. The Lancet 2007; 369(9561): 587-96. doi: 10.1016/s0140-6736(07)60279-7.
  • Cervera R, Khamashta MA, Font J, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore) 2003; 82: 299- 308. doi: 10.1097/01.md.000.009.1181.93122.55.
  • Yates M, Watts RA. EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis. 2016; 75: 1583-94. doi: 10.1136/annrheumdis-2016-209133.
  • Fanouriakis A, Kostopoulou M, Alunno A. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. 2019; 78: 736-45. doi: 10.1136/ annrheumdis-2019-215089.
  • Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis 2021; 80: 14-25. 20201013. doi: 10.1136/annrheumdis-2020-218272.
  • Anastasiou C, Dulai O, Baskaran A, Proudfoot J, Verhaegen S, Kalunian K. Immunosuppressant use and hospitalisations in adult patients with systemic lupus erythematosus admitted to a tertiary academic medical centre. Lupus Sci Med 2018; 5: e000249. 2018/06/30. doi: 10.1136/lupus-2017-000249.
  • Flossmann O, Berden A, de Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 2011; 70: 488-94. 2010/11/27. doi: 10.1136/ard.2010.137778.
  • Jones RB, Tervaert JW, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 2010; 363: 211-20. doi: 10.1056/NEJMoa0909169.
  • Stone JH, Merkel PA, Spiera R, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 2010; 363: 221-32. doi: 10.1056/NEJMoa0909905.
  • Roberts DM, Jones RB, Smith RM, et al. Rituximab-associated hypogammaglobulinemia: incidence, predictors and outcomes in patients with multi-system autoimmune disease. J Autoimmun 2015; 57: 60-5. 2015/01/06. doi: 10.1016/j. jaut.2014.11.009.
  • Barber C, Gold WL, Fortin PR. Infections in the lupus patient: perspectives on prevention. Curr Opin Rheumatol 2011; 23: 358-65. 2011/05/03. doi: 10.1097/BOR.0b013e3283476cd8.
  • Murdaca G, Orsi A, Spano F, et al. Vaccine-preventable infections in Systemic Lupus Erythematosus. Hum Vaccin Immunother 2016; 12: 632-43. 2016/01/12. doi: 10.1080/21645.515.2015.1107685.
  • Kronbichler A, Kerschbaum J, Gopaluni S. Trimethoprimsulfamethoxazole prophylaxis prevents severe/life-threatening infections following rituximab in antineutrophil cytoplasm antibody-associated vasculitis. 2018; 77: 1440-7. doi: 10.1136/ annrheumdis-2017-212861.
  • Park JW, Curtis JR, Jun KI, et al. Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients Receiving Rituximab. Chest 2022; 161: 1201-10. 20211114. doi: 10.1016/j. chest.2021.11.007.
  • Charlier C, Henegar C, Launay O, et al. Risk factors for major infections in Wegener granulomatosis: analysis of 113 patients. Ann Rheum Dis 2009; 68: 658-63. 2008/05/28. doi: 10.1136/ard.2008.088302.
  • Goupil R, Brachemi S, Nadeau-Fredette AC, et al. Lymphopenia and treatment-related infectious complications in ANCA-associated vasculitis. Clin J Am Soc Nephrol 2013; 8: 416-23. 2012/12/12. doi: 10.2215/cjn.07300712.
  • Ginzler EM, Dooley MA, Aranow C, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med 2005; 353: 2219-28. doi: 10.1056/NEJMoa043731.
  • Contreras G, Pardo V, Leclercq B, et al. Sequential therapies for proliferative lupus nephritis. N Engl J Med 2004; 350: 971- 80. 2004/03/05. doi: 10.1056/NEJMoa031855.
  • Zhong Z, Li H, Zhong H, Zhou T. Clinical efficacy and safety of rituximab in lupus nephritis. Drug Des Devel Ther 2019; 13: 845-56. doi: 10.2147/dddt.S195113.
  • Jones RB, Tervaert JW, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 2010; 363: 211-20. doi: 10.1056/NEJMoa0909169.
  • Specks U, Merkel PA, Seo P, et al. Efficacy of remissioninduction regimens for ANCA-associated vasculitis. N Engl J Med 2013; 369: 417-27. 2013/08/02. doi: 10.1056/ NEJMoa1213277.
  • Jones RB, Furuta S, Tervaert JW, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis: 2-year results of a randomised trial. Ann Rheum Dis 2015; 74: 1178-82. doi: 10.1136/annrheumdis-2014-206404.
  • Venhoff N, Effelsberg NM, Salzer U, et al. Impact of rituximab on immunoglobulin concentrations and B cell numbers after cyclophosphamide treatment in patients with ANCAassociated vasculitides. PLoS One 2012; 7: e37626. doi: 10.1371/journal.pone.0037626.
  • Besada E, Koldingsnes W, Nossent JC. Serum immunoglobulin levels and risk factors for hypogammaglobulinaemia during long-term maintenance therapy with rituximab in patients with granulomatosis with polyangiitis. Rheumatology (Oxford) 2014; 53: 1818-24. 2014/05/17. doi: 10.1093/ rheumatology/keu194.
  • Marco H, Smith RM, Jones RB, et al. The effect of rituximab therapy on immunoglobulin levels in patients with multisystem autoimmune disease. BMC Musculoskelet Disord 2014; 15: 178. doi: 10.1186/1471-2474-15-178.
  • 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 (Oxford) 2013; 52: 2041-7. doi: 10.1093/ rheumatology/ket257.

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

Year 2024, Volume: 37 Issue: 3, 268 - 273, 30.10.2024
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.

References

  • Robson J, Doll H, Suppiah R, et al. Damage in the ancaassociated vasculitides: long-term data from the European vasculitis study group (EUVAS) therapeutic trials. Ann Rheum Dis 2015; 74: 177-84. 20131115. doi: 10.1136/ annrheumdis-2013-203927.
  • D’Cruz DP, Khamashta MA, Hughes GRV. Systemic lupus erythematosus. The Lancet 2007; 369(9561): 587-96. doi: 10.1016/s0140-6736(07)60279-7.
  • Cervera R, Khamashta MA, Font J, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine (Baltimore) 2003; 82: 299- 308. doi: 10.1097/01.md.000.009.1181.93122.55.
  • Yates M, Watts RA. EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis. 2016; 75: 1583-94. doi: 10.1136/annrheumdis-2016-209133.
  • Fanouriakis A, Kostopoulou M, Alunno A. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. 2019; 78: 736-45. doi: 10.1136/ annrheumdis-2019-215089.
  • Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis 2021; 80: 14-25. 20201013. doi: 10.1136/annrheumdis-2020-218272.
  • Anastasiou C, Dulai O, Baskaran A, Proudfoot J, Verhaegen S, Kalunian K. Immunosuppressant use and hospitalisations in adult patients with systemic lupus erythematosus admitted to a tertiary academic medical centre. Lupus Sci Med 2018; 5: e000249. 2018/06/30. doi: 10.1136/lupus-2017-000249.
  • Flossmann O, Berden A, de Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 2011; 70: 488-94. 2010/11/27. doi: 10.1136/ard.2010.137778.
  • Jones RB, Tervaert JW, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 2010; 363: 211-20. doi: 10.1056/NEJMoa0909169.
  • Stone JH, Merkel PA, Spiera R, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 2010; 363: 221-32. doi: 10.1056/NEJMoa0909905.
  • Roberts DM, Jones RB, Smith RM, et al. Rituximab-associated hypogammaglobulinemia: incidence, predictors and outcomes in patients with multi-system autoimmune disease. J Autoimmun 2015; 57: 60-5. 2015/01/06. doi: 10.1016/j. jaut.2014.11.009.
  • Barber C, Gold WL, Fortin PR. Infections in the lupus patient: perspectives on prevention. Curr Opin Rheumatol 2011; 23: 358-65. 2011/05/03. doi: 10.1097/BOR.0b013e3283476cd8.
  • Murdaca G, Orsi A, Spano F, et al. Vaccine-preventable infections in Systemic Lupus Erythematosus. Hum Vaccin Immunother 2016; 12: 632-43. 2016/01/12. doi: 10.1080/21645.515.2015.1107685.
  • Kronbichler A, Kerschbaum J, Gopaluni S. Trimethoprimsulfamethoxazole prophylaxis prevents severe/life-threatening infections following rituximab in antineutrophil cytoplasm antibody-associated vasculitis. 2018; 77: 1440-7. doi: 10.1136/ annrheumdis-2017-212861.
  • Park JW, Curtis JR, Jun KI, et al. Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients Receiving Rituximab. Chest 2022; 161: 1201-10. 20211114. doi: 10.1016/j. chest.2021.11.007.
  • Charlier C, Henegar C, Launay O, et al. Risk factors for major infections in Wegener granulomatosis: analysis of 113 patients. Ann Rheum Dis 2009; 68: 658-63. 2008/05/28. doi: 10.1136/ard.2008.088302.
  • Goupil R, Brachemi S, Nadeau-Fredette AC, et al. Lymphopenia and treatment-related infectious complications in ANCA-associated vasculitis. Clin J Am Soc Nephrol 2013; 8: 416-23. 2012/12/12. doi: 10.2215/cjn.07300712.
  • Ginzler EM, Dooley MA, Aranow C, et al. Mycophenolate mofetil or intravenous cyclophosphamide for lupus nephritis. N Engl J Med 2005; 353: 2219-28. doi: 10.1056/NEJMoa043731.
  • Contreras G, Pardo V, Leclercq B, et al. Sequential therapies for proliferative lupus nephritis. N Engl J Med 2004; 350: 971- 80. 2004/03/05. doi: 10.1056/NEJMoa031855.
  • Zhong Z, Li H, Zhong H, Zhou T. Clinical efficacy and safety of rituximab in lupus nephritis. Drug Des Devel Ther 2019; 13: 845-56. doi: 10.2147/dddt.S195113.
  • Jones RB, Tervaert JW, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 2010; 363: 211-20. doi: 10.1056/NEJMoa0909169.
  • Specks U, Merkel PA, Seo P, et al. Efficacy of remissioninduction regimens for ANCA-associated vasculitis. N Engl J Med 2013; 369: 417-27. 2013/08/02. doi: 10.1056/ NEJMoa1213277.
  • Jones RB, Furuta S, Tervaert JW, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis: 2-year results of a randomised trial. Ann Rheum Dis 2015; 74: 1178-82. doi: 10.1136/annrheumdis-2014-206404.
  • Venhoff N, Effelsberg NM, Salzer U, et al. Impact of rituximab on immunoglobulin concentrations and B cell numbers after cyclophosphamide treatment in patients with ANCAassociated vasculitides. PLoS One 2012; 7: e37626. doi: 10.1371/journal.pone.0037626.
  • Besada E, Koldingsnes W, Nossent JC. Serum immunoglobulin levels and risk factors for hypogammaglobulinaemia during long-term maintenance therapy with rituximab in patients with granulomatosis with polyangiitis. Rheumatology (Oxford) 2014; 53: 1818-24. 2014/05/17. doi: 10.1093/ rheumatology/keu194.
  • Marco H, Smith RM, Jones RB, et al. The effect of rituximab therapy on immunoglobulin levels in patients with multisystem autoimmune disease. BMC Musculoskelet Disord 2014; 15: 178. doi: 10.1186/1471-2474-15-178.
  • 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 (Oxford) 2013; 52: 2041-7. doi: 10.1093/ rheumatology/ket257.
There are 27 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Original Research
Authors

Sultan Gözde Temiz 0000-0001-6382-3862

Dilek Barutcu Atas 0000-0002-3090-4479

Fatma Alibaz Öner 0000-0002-6653-1758

Arzu Velioglu 0000-0001-9750-7585

İzzet Hakkı Arıkan 0000-0001-6195-1932

Serhan Tuğlular 0000-0002-6384-1697

Haner Direskeneli 0000-0003-2598-5806

Ebru Aşıcıoğlu 0000-0002-5685-115X

Publication Date October 30, 2024
Submission Date January 29, 2024
Acceptance Date February 23, 2024
Published in Issue Year 2024 Volume: 37 Issue: 3

Cite

APA Temiz, S. G., Barutcu Atas, D., Alibaz Öner, F., Velioglu, A., et al. (2024). Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab. Marmara Medical Journal, 37(3), 268-273. https://doi.org/10.5472/marumj.1572912
AMA Temiz SG, Barutcu Atas D, Alibaz Öner F, Velioglu A, Arıkan İH, Tuğlular S, Direskeneli H, Aşıcıoğlu E. Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab. Marmara Med J. October 2024;37(3):268-273. doi:10.5472/marumj.1572912
Chicago Temiz, Sultan Gözde, Dilek Barutcu Atas, Fatma Alibaz Öner, Arzu Velioglu, İzzet Hakkı Arıkan, Serhan Tuğlular, Haner Direskeneli, and Ebru Aşıcıoğlu. “Infections in ANCA-Associated Vasculitis and Lupus Nephritis Treated With Rituximab”. Marmara Medical Journal 37, no. 3 (October 2024): 268-73. https://doi.org/10.5472/marumj.1572912.
EndNote Temiz SG, Barutcu Atas D, Alibaz Öner F, Velioglu A, Arıkan İH, Tuğlular S, Direskeneli H, Aşıcıoğlu E (October 1, 2024) Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab. Marmara Medical Journal 37 3 268–273.
IEEE S. G. Temiz, D. Barutcu Atas, F. Alibaz Öner, A. Velioglu, İ. H. Arıkan, S. Tuğlular, H. Direskeneli, and E. Aşıcıoğlu, “Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab”, Marmara Med J, vol. 37, no. 3, pp. 268–273, 2024, doi: 10.5472/marumj.1572912.
ISNAD Temiz, Sultan Gözde et al. “Infections in ANCA-Associated Vasculitis and Lupus Nephritis Treated With Rituximab”. Marmara Medical Journal 37/3 (October 2024), 268-273. https://doi.org/10.5472/marumj.1572912.
JAMA Temiz SG, Barutcu Atas D, Alibaz Öner F, Velioglu A, Arıkan İH, Tuğlular S, Direskeneli H, Aşıcıoğlu E. Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab. Marmara Med J. 2024;37:268–273.
MLA Temiz, Sultan Gözde et al. “Infections in ANCA-Associated Vasculitis and Lupus Nephritis Treated With Rituximab”. Marmara Medical Journal, vol. 37, no. 3, 2024, pp. 268-73, doi:10.5472/marumj.1572912.
Vancouver Temiz SG, Barutcu Atas D, Alibaz Öner F, Velioglu A, Arıkan İH, Tuğlular S, Direskeneli H, Aşıcıoğlu E. Infections in ANCA-associated vasculitis and lupus nephritis treated with rituximab. Marmara Med J. 2024;37(3):268-73.