利妥昔单抗治疗荚膜细胞病成人患者的长期疗效

IF 10.3 1区 医学 Q1 UROLOGY & NEPHROLOGY
Philipp Gauckler, Anna Matyjek, Seleni Kapsia, Smaragdi Marinaki, Luis F Quintana, Montserrat M Diaz, Catherine King, Siân Griffin, Raja Ramachandran, Balazs Odler, Kathrin Eller, Ayşe Serra Artan, Safak Mirioglu, Martin Busch, Maxi Schaepe, Kultigin Turkmen, Chee Kay Cheung, Ruth J Pepper, Gema Fernandez Juarez, Julio Pascual, Pilar Auñón, Clara García-Carro, Antolina Rodriguez, Federico Alberici, Leonella Luzardo, Natalia Chebotareva, Ulf Schönermarck, Loreto Fernández, Jai Radhakrishnan, Karina Guaman, Yonatan Peleg, Léa Hoisnard, Vincent Audard, Marios Papasotiriou, Nina Krnanska, Vladimir Tesar, Zdenka Hruskova, Annette Bruchfeld, Maria Stangou, Georgios Lioulios, Stanislas Faguer, David Ribes, Sofiane Salhi, Martin Windpessl, Krešimir Galešić, Matija Crnogorac, Nikola Zagorec, Gert Mayer, Andreas Kronbichler
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引用次数: 0

摘要

背景:接受利妥昔单抗治疗的荚膜病变(极小变化疾病或局灶节段性肾小球硬化症)成人患者的长期疗效尚不清楚:接受利妥昔单抗治疗的荚膜细胞病变(微小病变或局灶节段性肾小球硬化症)成人患者的长期预后在很大程度上是未知的:全球 15 个国家的 30 个肾脏科开展了一项回顾性研究,研究对象包括接受过利妥昔单抗治疗、临床随访至少 36 个月的原发性荚膜细胞病成人患者。主要结果是 36 个月的无复发存活率:183名患有难治性肾病综合征(68%依赖类固醇/经常复发,22%耐类固醇,85%曾接受过两种或两种以上免疫抑制剂治疗)的成人患者(64人患有局灶节段性肾小球硬化症,119人患有微小病变)接受了利妥昔单抗治疗,作为缓解诱导方案的一部分。82%的患者在接受利妥昔单抗治疗6个月后获得完全或部分缓解。151名初次应答者中有83人(55%)在三年内实现了长期无复发生存。无论采用哪种给药方案,利妥昔单抗维持治疗都能提高无复发生存率(HR 2.05,95% CI:1.07-3.91)。在36个月时,接受利妥昔单抗维持治疗的初始应答者中有61%实现了长期无复发生存并停用了所有伴随的免疫抑制药物,而未接受维持治疗的患者中仅有36%实现了长期无复发生存(OR 2.69,95% CI:1.27-5.73)。利妥昔单抗启动后,每年的复发率从之前的1.0(95% CI:1.0-1.7)降至0.17(95% CI:0.00-0.24)。在36个月的随访中,最初应答者的估计肾小球滤过率(eGFR)完全或部分缓解,而未应答者的eGFR下降至-11(95% CI:-18至-8)毫升/分/1.73平方米:利妥昔单抗有助于大多数难治性荚膜细胞病成人患者获得初始和长期应答。利妥昔单抗的维持治疗进一步提高了患者三年以上的长期无复发生存率。对初始利妥昔单抗治疗无反应与肾脏预后不良有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Outcomes of Rituximab-Treated Adult Patients with Podocytopathies.
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来源期刊
Journal of The American Society of Nephrology
Journal of The American Society of Nephrology 医学-泌尿学与肾脏学
CiteScore
22.40
自引率
2.90%
发文量
492
审稿时长
3-8 weeks
期刊介绍: The Journal of the American Society of Nephrology (JASN) stands as the preeminent kidney journal globally, offering an exceptional synthesis of cutting-edge basic research, clinical epidemiology, meta-analysis, and relevant editorial content. Representing a comprehensive resource, JASN encompasses clinical research, editorials distilling key findings, perspectives, and timely reviews. Editorials are skillfully crafted to elucidate the essential insights of the parent article, while JASN actively encourages the submission of Letters to the Editor discussing recently published articles. The reviews featured in JASN are consistently erudite and comprehensive, providing thorough coverage of respective fields. Since its inception in July 1990, JASN has been a monthly publication. JASN publishes original research reports and editorial content across a spectrum of basic and clinical science relevant to the broad discipline of nephrology. Topics covered include renal cell biology, developmental biology of the kidney, genetics of kidney disease, cell and transport physiology, hemodynamics and vascular regulation, mechanisms of blood pressure regulation, renal immunology, kidney pathology, pathophysiology of kidney diseases, nephrolithiasis, clinical nephrology (including dialysis and transplantation), and hypertension. Furthermore, articles addressing healthcare policy and care delivery issues relevant to nephrology are warmly welcomed.
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