Desenlaces con el uso de rituximab en pacientes con nefritis lúpica refractaria en una cohorte colombiana

Abstract

Introduction/ObjectiveTo describe the safety and response to treatment with rituximab (RTX), estimating its impact on the health state utility (HSU) of patients with refractory lupus nephritis (LN) treated in referral centres in several cities in Colombia. Materials and methodsA registry-based follow-up study. Patients aged between 16 and 75years, who were refractory to first-line management and had ISN/RPS class III-IV (±V) LN, were included. Our primary outcome was total or partial response to treatment; secondary outcomes were HSU measured with the EQ-5D-3L, and safety of treatment with RTX. The impact analysis of response to RTX on HSU were performed by mean difference estimated by robust regression. ResultsForty-six patients (44 women) were included, with a median age of 34years (IQR=13), the median SDI was1 (IQR=1) and the median activity measured by SLEDAI was 4.5 (IQR=5.9). Response to RTX was observed in 27 (58.7%) patients. Adjusted for SLEDAI and co-interventions, the patients who responded to RTX obtained a higher mean HSU by 0.162 (95%CI: 0.006-0.317). Which is equivalent to 1.9 (95%CI: 0.2-3.8) more months lived in ideal health conditions for each year with refractory LN. In 54.3% of the patients, RTX had adequate safety. ConclusionFrom the patient's perspective, the response to treatment with RTX in patients with refractory LN implies a significant impact on their quality of life.