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| ORIGINAL ARTICLE |
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| Year : 2015 |
Volume
: 26 | Issue : 1 | Page
: 47-55 |
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Rituximab as a rescue therapy in patients with glomerulonephritis
Muhammad Ziad Souqiyyeh1, Faissal A. M. Shaheen1, Abdulkareem Alsuwaida2, Mohammed Alghonaim2, Jamal Alwakeel2, Dujana Mosa3, Faheem Akhtar3, Ebadur Rahman3, Maged Hussein4, Hysam Roujouleh5, Nauman Siddiqi5, Ibtissam Bukhari5, Nihal Sadaqa5, Faissal Mushtaque6, Neveen Mustafa Awn6, Fouad Shariya6, Adnan Alfi7, Mohammad Amin7, Mustafa Ahmad8, Fadel Abbas Rowaie8, Samir Almueilo9, Mohamed Chihab Eddine Kechrid10, Ayman Karkar11
1 The Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
2 King Khaled University Hospital, Riyadh, Saudi Arabia
3 Prince Sultan Military Medical Center, Riyadh, Saudi Arabia
4 King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
5 Armed Forces Hospital, Jeddah, Saudi Arabia
6 King Fahad Hospital, Jeddah, Saudi Arabia
7 King Abdulaziz Hospital, Jeddah, Saudi Arabia
8 King Fahad Medical City, Riyadh, Saudi Arabia
9 King Fahad Hospital of the University, Alkhober, Saudi Arabia
10 Security Forces Hospital, Riyadh, Saudi Arabia
11 Dammam Medical Complex, Dammam, Saudi Arabia
Correspondence Address:
Muhammad Ziad Souqiyyeh
Saudi Center for Organ Transplantation, P. O. Box 27049, Riyadh 11417
Saudi Arabia
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DOI: 10.4103/1319-2442.148733 PMID: 25579715 
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To evaluate the use of rituximab in the treatment of severe glomerulonephritis (GN) in order to prevent progression of kidney disease toward the end stage, we designed a multicenter, retrospective study in Saudi Arabia about the efficacy and safety of the use of "off label" rituximab in a variety of severe refractory GN to conventional treatment and the progression of kidney disease for at least one year of follow-up. All the patients had kidney biopsies before treatment with rituximab, and proteinuria and glomerular filtration rate (GFR) were followed-up for the period of the study. The immediate side-effect at the time of administration of rituximab included itching in three patients, hypotension in one patient and anaphylaxis in one patient (dropped out from the study). After the administration of rituximab in 42 patients and during the first six months of therapy, 16 (38%) patients had complete remission (CR), 13 (31%) patients had partial remission (PR) and 13 (31%) patients had no remission. The mean follow-up period for the patients was 19.0 ± 6.97 months (median 18.0 months). The long-term follow-up during the study period disclosed a good hospitalization record for almost all of the patients. Membranous GN (MGN) was the largest group in the cohort (58% of the patients), and we observed CR and PR in 40% and 28% of them, respectively, which was comparable with the previous experience with rituximab in MGN patients with more CR than PR in our cohort. We conclude that our study suggests the safety and efficacy of the use of rituximab in patients with refractory GN and that larger and long-term prospective studies are required to define the role of rituximab in the different categories of these diseases. |
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