TMA secondary to SLE: rituximab improves overall but not renal survival
Abstract Thrombotic microangiopathy (TMA) includes a series of life-threatening disorders. Systemic lupus erythematosus (SLE) is one of the most common acquired causes. To identify predictors of prognosis in patients with TMA secondary to SLE, we conducted a single-center historical study. From January 2013 to June 2016, of 2182 SLE hospitalized patients in the Ren Ji Hospital, a total of 21 consecutive patients with TMA secondary to SLE were identified. The 90-day short-term mortality was 33.3%. The kidney involvement (66.7%) was associated with poor prognosis, while the administration of rituximab (n = 13) was an independent protective factor according to logistic regression analysis. Compared to conventional treatment, i.e., plasma exchange, high-dose glucocorticoids, and intravenous immunoglobulin, the overall survival is significantly higher among patients receiving rituximab add-on (92.2 vs 33.3%, p = 0.0173); however, five out of seven patients with renal involvement in the rituximab group were eventually hemodialysis dependent. Our data indicated that add-on rituximab in the background of conventional therapy may improve the overall but not the renal survival in SLE-TMA patients..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
Clinical rheumatology - 37(2017), 1 vom: 30. Aug., Seite 213-218 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sun, Fangfang [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Rituximab |
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| Anmerkungen: |
© International League of Associations for Rheumatology (ILAR) 2017 |
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| doi: |
10.1007/s10067-017-3793-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC2025714416 |
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| 520 | |a Abstract Thrombotic microangiopathy (TMA) includes a series of life-threatening disorders. Systemic lupus erythematosus (SLE) is one of the most common acquired causes. To identify predictors of prognosis in patients with TMA secondary to SLE, we conducted a single-center historical study. From January 2013 to June 2016, of 2182 SLE hospitalized patients in the Ren Ji Hospital, a total of 21 consecutive patients with TMA secondary to SLE were identified. The 90-day short-term mortality was 33.3%. The kidney involvement (66.7%) was associated with poor prognosis, while the administration of rituximab (n = 13) was an independent protective factor according to logistic regression analysis. Compared to conventional treatment, i.e., plasma exchange, high-dose glucocorticoids, and intravenous immunoglobulin, the overall survival is significantly higher among patients receiving rituximab add-on (92.2 vs 33.3%, p = 0.0173); however, five out of seven patients with renal involvement in the rituximab group were eventually hemodialysis dependent. Our data indicated that add-on rituximab in the background of conventional therapy may improve the overall but not the renal survival in SLE-TMA patients. | ||
| 650 | 4 | |a Rituximab | |
| 650 | 4 | |a Systemic lupus erythematosus | |
| 650 | 4 | |a Thrombotic microangiopathy | |
| 650 | 4 | |a Thrombotic thrombocytopenic purpura | |
| 700 | 1 | |a Wang, Xiaodong |4 aut | |
| 700 | 1 | |a Wu, Wanlong |4 aut | |
| 700 | 1 | |a Wang, Kaiwen |4 aut | |
| 700 | 1 | |a Chen, Zhiwei |4 aut | |
| 700 | 1 | |a Li, Ting |4 aut | |
| 700 | 1 | |a Ye, Shuang |4 aut | |
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