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10.1002/acr.22993 http://scihub22266oqcxt.onion/10.1002/acr.22993 C5485064!5485064 !27428176     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=27428176 &cmd=llinks): Failed to open stream: HTTP request failed! 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Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long-Term Effects on Serum Immunoglobulins |pdf=|usr=}}{{27428176 }} gab.com Text Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long-Term Effects on Serum Immunoglobulins JO: Arthritis Care Res (Hoboken) http://www.kidney.de/pget.php?&tw=1&pmid=27428176 #FOAvip OBJECTIVE: B cell-depletion therapy based on rituximab is a therapeutic option for refractory disease in patients with systemic lupus erythematosus (SLE). The aim of this observational study was to document long-term effects on B cell function by following serum immunoglobulin levels in patients with SLE treated with rituximab in routine clinical practice. METHODS: We included 57 consecutive patients with SLE treated with rituximab and concomitant/sequential immunosuppressants and measured serum total IgG, IgM, and IgA and IgG anti-dsDNA antibodies, over a median of 48 months most recent followup. Flow cytometry was used prospectively to assess B cell phenotypes in 17 of 57 patients. RESULTS: Twelve patients (21%) had persistent IgM hypogammaglobulinemia (<0.4 gm/liter), and 4 of 57 (5%) had low IgG (<7 gm/liter) at the most recent followup (range 12-144 months). This was not associated with serious adverse events or high anti-double-stranded DNA (anti-dsDNA) antibodies (>1,000 IU/ml; normal <50 IU/ml). Factors predictive of low serum IgM included baseline serum IgM ?0.8 gm/liter (receiver operator curve analysis) and subsequent therapy with mycophenolate mofetil (MMF; odds ratio 6.8, compared with other immunosuppressants). In patients maintaining normal IgM levels (9 of 17), the frequency of circulating IgD+CD27+ B cells was significantly higher (P?=?0.05). At 12 months after rituximab, 7 of 30 SLE patients with baseline anti-dsDNA ?1,000 IU/ml had lost seropositivity. CONCLUSION: Lower baseline serum IgM levels and sequential therapy with MMF were predictive of IgM hypogammaglobulinemia after rituximab in SLE, but this was not associated with higher levels of anti-dsDNA antibodies or an increased risk of infections. This provides useful directions for clinicians regarding rituximab and sequential immunosuppressive treatment for patients with SLE. Twit Text FOAVip Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long-Term Effects on Serum Immunoglobulins ????Arthritis Care Res (Hoboken) http://www.kidney.de/pget.php?&tw=1&pmid=27428176 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=27428176 #FOAvip English Wikipedia <ref>{{Cite pmid|27428176 }}</ref> Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long-Term Effects on Serum Immunoglobulins #MMPMID27428176 Reddy V ; Martinez L ; Isenberg DA ; Leandro MJ ; Cambridge G Arthritis Care Res (Hoboken) 2017[Jun]; 69 (6 ): 857-866 PMID27428176 show ga OBJECTIVE: B cell-depletion therapy based on rituximab is a therapeutic option for refractory disease in patients with systemic lupus erythematosus (SLE). The aim of this observational study was to document long-term effects on B cell function by following serum immunoglobulin levels in patients with SLE treated with rituximab in routine clinical practice. METHODS: We included 57 consecutive patients with SLE treated with rituximab and concomitant/sequential immunosuppressants and measured serum total IgG, IgM, and IgA and IgG anti-dsDNA antibodies, over a median of 48 months most recent followup. Flow cytometry was used prospectively to assess B cell phenotypes in 17 of 57 patients. RESULTS: Twelve patients (21%) had persistent IgM hypogammaglobulinemia (<0.4 gm/liter), and 4 of 57 (5%) had low IgG (<7 gm/liter) at the most recent followup (range 12-144 months). This was not associated with serious adverse events or high anti-double-stranded DNA (anti-dsDNA) antibodies (>1,000 IU/ml; normal <50 IU/ml). Factors predictive of low serum IgM included baseline serum IgM ?0.8 gm/liter (receiver operator curve analysis) and subsequent therapy with mycophenolate mofetil (MMF; odds ratio 6.8, compared with other immunosuppressants). In patients maintaining normal IgM levels (9 of 17), the frequency of circulating IgD+CD27+ B cells was significantly higher (P?=?0.05). At 12 months after rituximab, 7 of 30 SLE patients with baseline anti-dsDNA ?1,000 IU/ml had lost seropositivity. CONCLUSION: Lower baseline serum IgM levels and sequential therapy with MMF were predictive of IgM hypogammaglobulinemia after rituximab in SLE, but this was not associated with higher levels of anti-dsDNA antibodies or an increased risk of infections. This provides useful directions for clinicians regarding rituximab and sequential immunosuppressive treatment for patients with SLE. |Adolescent [MESH] |Adult [MESH] |Aged [MESH] |Antirheumatic Agents/*therapeutic use [MESH] |Biomarkers/blood [MESH] |Cross-Sectional Studies [MESH] |Female [MESH] |Follow-Up Studies [MESH] |Humans [MESH] |Immunoglobulin M/*blood [MESH] |Lupus Erythematosus, Systemic/*blood/diagnosis/*drug therapy [MESH] |Male [MESH] |Middle Aged [MESH] |Rituximab/pharmacology/*therapeutic use [MESH] |Time Factors [MESH] |Treatment Outcome [MESH]Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With(epmc).pdf DeepDyve Pubget Overpricing