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논문 기본 정보

자료유형
학술저널
저자정보
최수진 (울산대학교 의과대학 서울아산병원 내과) 안수민 (울산대학교 의과대학 서울아산병원 류마티스내과) 오지선 (서울아산병원) 홍석찬 (서울아산병원) 이창근 (울산대학교) 유빈 (울산대학교) 김용길 (울산대학교)
저널정보
대한류마티스학회 대한류마티스학회지 대한류마티스학회지 제29권 제1호
발행연도
2022.1
수록면
22 - 32 (11page)
DOI
10.4078/jrd.2022.29.1.22

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Objective. Previous studies investigating the beneficial effect of rituximab on lupus nephritis (LN) reported controversial results. There have been few reports of renal response to rituximab according to renal function. We investigated the efficacy of rituximab in refractory/relapsing LN and the role of renal function as a predictor of renal response. Methods. From 2016 to 2019, we retrospectively reviewed 22 patients with refractory/relapsing LN receiving rituximab. Renal responses (complete and partial) at 6 and 12 months were compared between normal (glomerular filtration rate [GFR]≥90 mL/min/1.73 m2, n=11) and decreased (GFR<90 mL/min/1.73 m2, n=11) GFR groups. Multivariate Cox regression analysis was used to assess predictors of renal response. Results. At baseline, the decreased GFR group had a higher urine proteinuria to creatinine ratio (p=0.008) and proportion of refractory LN (p=0.010) and previous cyclophosphamide therapy (p=0.035) than the normal GFR group. The overall renal response rate was 45.5% (10 patients) at 6 months and 54.5% (12 patients) at 12 months. Renal response rates were higher in the normal GFR group (81.8% and 90.9% at 6 and 12 months, respectively) than in the decreased GFR group (9.1% and 18.2% at 6 and 12 months, respectively; p<0.001). Normal GFR and anti-La were associated with renal response to rituximab, with hazard ratios of 9.256 (p=0.008) and 5.478 (p=0.041), respectively. Conclusion. Rituximab is an effective therapy for refractory/relapsing LN, particularly in patients with preserved renal function.

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