Severe Infections following Rituximab Treatment in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.

Abstract

INTRODUCTION:

Severe infections were not rare in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients treated with rituximab. The current study aimed to evaluate severe infections in AAV patients received rituximab administration in a single Chinese center.

METHODS:

Twenty-seven patients were retrospectively included in this study. Their demographic and clinical data were analyzed. Severe infections were classified as grade ≥3 as proposed by the Common Terminology Criteria for Adverse Events V.4.0.

RESULTS:

Patients were followed up for 23.6 ± 14.0 months from the time of rituximab initiation (mean rituximab dose 1,270.4 mg). Ten severe infection events were recorded in 10 (37.0%) patients, corresponding to an event rate of 20.9 per 100 person-years. Pulmonary infections were the leading infectious complications (90%). Eight of the 10 infections occurred during the first 12 months of follow-up. In multivariable analysis, severe infection in the first year was independently associated with age (HR: 1.121, 95% CI: 1.011-1.243, p = 0.031) and serum creatinine level (increased by per 88.4 μmol/L; HR: 1.493, 95% CI: 1.017-2.191, p = 0.041).

CONCLUSION:

In AAV patients receiving ri-tuximab, severe infections were common even with the low-dose regimen. Pulmonary infections were the leading cause, and most infections occurred during the first 12 months of follow-up. Older age and renal dysfunction were the risk factors for infection.

• Authors: Zhi-Ying Li, Min Chen, Ming-Hui Zhao
• Journal: Kidney diseases (Basel, Switzerland) (Kidney Dis (Basel)) Vol. 7 Issue 1 Pg. 50-56 (Jan 2021) ISSN: 2296-9381 [Print] Switzerland
• PMID: 33614733 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 by S. Karger AG, Basel.