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The Risk of Severe Infections Following Rituximab Administration in Patients With Autoimmune Kidney Diseases: Austrian ABCDE Registry Analysis.

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cam.issuedOnline2021-10-29
dc.contributor.authorOdler, Balazs
dc.contributor.authorWindpessl, Martin
dc.contributor.authorKrall, Marcell
dc.contributor.authorSteiner, Maria
dc.contributor.authorRiedl, Regina
dc.contributor.authorHebesberger, Carina
dc.contributor.authorUrsli, Martin
dc.contributor.authorZitt, Emanuel
dc.contributor.authorLhotta, Karl
dc.contributor.authorAntlanger, Marlies
dc.contributor.authorCejka, Daniel
dc.contributor.authorGauckler, Philipp
dc.contributor.authorWiesholzer, Martin
dc.contributor.authorSaemann, Marcus
dc.contributor.authorRosenkranz, Alexander R
dc.contributor.authorEller, Kathrin
dc.contributor.authorKronbichler, Andreas
dc.contributor.orcidKronbichler, Andreas [0000-0002-2945-2946]
dc.date.accessioned2021-11-22T14:33:44Z
dc.date.available2021-11-22T14:33:44Z
dc.date.issued2021
dc.date.submitted2021-08-18
dc.date.updated2021-11-22T14:33:44Z
dc.description.abstractOBJECTIVE: To characterize the incidence, type, and risk factors of severe infections (SI) in patients with autoimmune kidney diseases treated with rituximab (RTX). METHODS: We conducted a multicenter retrospective cohort study of adult patients with immune-related kidney diseases treated with at least one course of RTX between 2015 and 2019. As a part of the ABCDE Registry, detailed data on RTX application and SI were collected. SI were defined by Common Terminology Criteria for Adverse Events v5.0 as infectious complications grade 3 and above. Patients were dichotomized between "nephrotic" and "nephritic" indications. The primary outcome was the incidence of SI within 12 months after the first RTX application. RESULTS: A total of 144 patients were included. Twenty-five patients (17.4%) presented with SI, mostly within the first 3 months after RTX administration. Most patients in the nephritic group had ANCA-associated vasculitis, while membranous nephropathy was the leading entity in the nephrotic group. Respiratory infections were the leading SI (n= 10, 40%), followed by urinary tract (n=3, 12%) and gastrointestinal infections (n=2, 8%). On multivariable analysis, body mass index (BMI, 24.6 kg/m2versus 26.9 kg/m2, HR: 0.88; 95%CI: 0.79-0.99; p=0.039) and baseline creatinine (HR: 1.25; 95%CI: 1.04-1.49; p=0.017) were significantly associated with SI. All patients in the nephritic group (n=19; 100%) who experienced a SI received oral glucocorticoid (GC) treatment at the time of infection. Hypogammaglobulinemia was frequent (58.5%) but not associated with SI. CONCLUSIONS: After RTX administration, impaired kidney function and lower BMI are independent risk factors for SI. Patients with nephritic glomerular diseases having concomitant GC treatment might be at higher risk of developing SI.
dc.identifier.doi10.17863/CAM.78210
dc.identifier.eissn1664-3224
dc.identifier.issn1664-3224
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/330767
dc.languageen
dc.language.isoeng
dc.publisherFrontiers Media SA
dc.publisher.urlhttp://dx.doi.org/10.3389/fimmu.2021.760708
dc.subjectglomerular disease
dc.subjectinfections
dc.subjectlupus
dc.subjectnephritic
dc.subjectnephrotic
dc.subjectrituximab
dc.subjectvasculitis
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectAustria
dc.subjectAutoimmune Diseases
dc.subjectBody Mass Index
dc.subjectFemale
dc.subjectHumans
dc.subjectImmunologic Factors
dc.subjectIncidence
dc.subjectInfections
dc.subjectKaplan-Meier Estimate
dc.subjectKidney Diseases
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProportional Hazards Models
dc.subjectRegistries
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectRituximab
dc.subjectYoung Adult
dc.titleThe Risk of Severe Infections Following Rituximab Administration in Patients With Autoimmune Kidney Diseases: Austrian ABCDE Registry Analysis.
dc.typeArticle
dcterms.dateAccepted2021-10-14
prism.publicationNameFront Immunol
prism.volume12
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.versionVoR
rioxxterms.versionofrecord10.3389/fimmu.2021.760708

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