Single-dose rituximab in refractory lupus nephritis.

Abstract:

BACKGROUND:Off-label use of rituximab in lupus nephritis is reported to be beneficial. While the optimal dose is unknown, the regimen of four intravenous doses of 375 mg/m(2) is commonly employed, despite expense and potential side-effects. AIM:To investigate the response to single-dose rituximab, added to standard corticosteroids plus additional immunosuppressive agent, in refractory lupus nephritis. METHODS:Consecutive consenting patients with refractory lupus nephritis despite steroids plus either cyclophosphamide, mycophenolate or azathioprine were enrolled in this ethics-approved, open-label, prospective study. After baseline assessment, patients received one intravenous infusion of 375 mg/m(2) rituximab. Clinical, biochemical and serological (DsDNA, complement) responses to this dose were analysed. Complete renal response (CR) was defined as normalisation of creatinine, albumin, proteinuria and urinary RBCs and partial response (PR) as ≥50% improvement in at least one parameter, without deterioration in others. B-cell depletion was defined as peripheral CD19 lymphocyte count ≤0.05 × 10(9) /L. RESULTS:Fourteen patients were enrolled in the study. All were B-cell-depleted until 8 months post-dose. Eleven patients (79%) responded (2CR, 9PR) at a median time of 5 months, with a 6-month probability of renal response of 43%. Five patients (45%) relapsed at a median time of 17 months. DsDNA titres decreased in 69%. Side-effects were minimal. CONCLUSIONS:Single-dose rituximab is effective in relapsed/refractory lupus nephritis. Longevity of B-cell depletion with single-dose rituximab is similar to that of four doses with potentially fewer side-effects.

journal_name

Intern Med J

authors

Kotagiri P,Martin A,Hughes P,Becker G,Nicholls K

doi

10.1111/imj.13136

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

899-901

issue

8

eissn

1444-0903

issn

1445-5994

journal_volume

46

pub_type

杂志文章
  • Prevalence and predictors of premature discontinuation of dual antiplatelet therapy after drug-eluting stent implantation: importance of social factors in Asian patients.

    abstract:AIM:Premature discontinuation of antiplatelet therapy is an independent predictor of late stent thrombosis. We sought to determine the prevalence and predictors of premature discontinuation of antiplatelet therapy after drug-eluting stent implantation among patients in Asia. METHODS:A total of 207 consecutive patients...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2009.02104.x

    authors: Poh CL,Chan MY,Lau C,Teo SG,Low AF,Tan HC,Lee CH

    更新日期:2011-08-01 00:00:00

  • Effectiveness of biologics in Australian patients with rheumatoid arthritis: a large observational study: REAL.

    abstract:BACKGROUND:The comparative effectiveness of biologic treatment regimens in a real world Australian population is unknown. AIM:To assess the effectiveness of biological disease-modifying anti-rheumatic drugs (bDMARD) as monotherapy or in combination with methotrexate and/or other conventional DMARD (cDMARD) for the tre...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,多中心研究

    doi:10.1111/imj.14028

    authors: Nicholls D,Barrett R,Button P,Truman M,Bird P,Roberts L,Tymms K,Littlejohn G,Griffiths H

    更新日期:2018-10-01 00:00:00

  • Prevalence of systemic anticancer therapy for patients within the last 30 days of life: experience in a private hospital oncology group.

    abstract:BACKGROUND:In recent years, there has been a significant increase in the number of cancer treatments that have become available. However, it has remained difficult to choose the most appropriate time to cease active therapy in individual patients. AIMS:To determine the proportion of patients being treated with palliat...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13260

    authors: Wein L,Rowe C,Brady B,Handolias D,Lipton L,Pook D,Stanley R,Haines I

    更新日期:2017-03-01 00:00:00

  • Management of systemic AL amyloidosis: recommendations of the Myeloma Foundation of Australia Medical and Scientific Advisory Group.

    abstract::Systemic AL amyloidosis is a plasma cell dyscrasia with a characteristic clinical phenotype caused by multi-organ deposition of an amyloidogenic monoclonal protein. This condition poses a unique management challenge due to the complexity of the clinical presentation and the narrow therapeutic window of available thera...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.12566

    authors: Weber N,Mollee P,Augustson B,Brown R,Catley L,Gibson J,Harrison S,Ho PJ,Horvath N,Jaksic W,Joshua D,Quach H,Roberts AW,Spencer A,Szer J,Talaulikar D,To B,Zannettino A,Prince HM

    更新日期:2015-04-01 00:00:00

  • Focal segmental glomerulosclerosis and Guillain-Barre syndrome associated with Campylobacter enteritis.

    abstract::Previous reports have noted an association between membranous nephropathy and focal segmental glomerulosclerosis with Guillain-Barre syndrome. We report a case of Campylobacter enteritis, which was complicated by both focal segmental glomerulosclerosis of the collapsing variety and Guillain-Barre syndrome, and propose...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2007.01458.x

    authors: Lim A,Lydia A,Rim H,Dowling J,Kerr P

    更新日期:2007-10-01 00:00:00

  • Polycystic ovary syndrome: a common hormonal condition with major metabolic sequelae that physicians should know about.

    abstract::Polycystic ovary syndrome (PCOS) is a prevalent, chronic and heterogeneous endocrine condition, with reproductive, metabolic and psychological features. Insulin resistance and hyperandrogenaemia are the key pathophysiological hormonal abnormalities. Insulin resistance is a significant contributor to the reproductive a...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.12495

    authors: Shorakae S,Boyle J,Teede H

    更新日期:2014-08-01 00:00:00

  • Mortality and airflow obstruction in asthma: a 17-year follow-up study.

    abstract:BACKGROUND:Asthma is associated with fixed airflow obstruction and an increased risk of death. The aim of this study was to relate asthma mortality and airflow obstruction to severity of asthma in a cohort of patients with chronic asthma studied over a 17-year period. METHODS:In 1980, asthma severity based on symptoms...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2006.01214.x

    authors: Panizza JA,James AL,Ryan G,de Klerk N,Finucane KE

    更新日期:2006-12-01 00:00:00

  • Don't forget shared decision-making in the COVID-19 crisis.

    abstract::Mechanical ventilation as a resource is limited and may lead to poor outcomes in at-risk populations. Critical care supports may not be preferred by those at risk of deterioration in the COVID-19 setting. Patient-centred communication and shared decision-making should continue to remain central to clinical practice. ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14862

    authors: Simpson N,Milnes S,Steinfort D

    更新日期:2020-06-01 00:00:00

  • Legionella pneumophila lung abscess associated with immune suppression.

    abstract::Legionella species are a common cause of community-acquired pneumonia, infrequently complicated by cavitary disease. We describe Legionella pneumophila pneumonia and abscess formation in an immunosuppressed patient receiving corticosteroid therapy for metastatic breast carcinoma. The predisposing role of corticosteroi...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2011.02508.x

    authors: Guy SD,Worth LJ,Thursky KA,Francis PA,Slavin MA

    更新日期:2011-10-01 00:00:00

  • Basal serum cortisol levels predict a normal response to the Synacthen stimulation test in hospitalized patients.

    abstract:BACKGROUND:The short Synacthen test is widely used to assess the hypothalamus pituitary adrenal axis in the outpatient setting. In the inpatient setting however, technical difficulties to adhere to the protocol may pose a challenge for using this test. AIMS:In this study we attempted to find the most suitable basal se...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.15033

    authors: Tolkin L,Vidberg M,Munter G

    更新日期:2020-08-24 00:00:00

  • High-dose cytarabine (24 g/m2) in combination with idarubicin (HiDAC-3) results in high first-cycle response with limited gastrointestinal toxicity in adult acute myeloid leukaemia.

    abstract:BACKGROUND/AIM:Although induction chemotherapy comprising high-dose cytarabine (HiDAC) in combination with idarubicin and etoposide or 'ICE' for adult acute myeloid leukaemia (AML) produces a complete remission rate of nearly 80%, gastrointestinal toxicity is significant. Omission of etoposide may produce similar clini...

    journal_title:Internal medicine journal

    pub_type: 临床试验,杂志文章,评审

    doi:10.1111/j.1445-5994.2012.02868.x

    authors: Low M,Lee D,Coutsouvelis J,Patil S,Opat S,Walker P,Schwarer A,Salem H,Avery S,Spencer A,Wei A

    更新日期:2013-03-01 00:00:00

  • Disparities in the incidence of acute myocardial infarction: long-term trends from the Hunter region.

    abstract:BACKGROUND:Trends in the incidence of acute myocardial infarction (AMI) provide important information for healthcare providers and can allow for accurate planning of future health needs and targeted interventions in areas with an excess burden of cardiovascular disease. AIM:To investigate the regional variations in AM...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13399

    authors: Davies AJ,Naudin C,Al-Omary M,Khan A,Oldmeadow C,Jones M,Bastian B,Bhagwandeen R,Fletcher P,Leitch J,Boyle A

    更新日期:2017-05-01 00:00:00

  • The efficacy and tolerability of febuxostat in gout patients on dialysis.

    abstract:BACKGROUND:There are no sufficient data available on the use of febuxostat in patients undergoing dialysis. AIM:We investigated the efficacy and tolerability of febuxostat in gout patients on dialysis. METHODS:We retrospectively reviewed clinical and laboratory data available from a referral center from January 2012 ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14776

    authors: Choi SY,Choi SW,Lee S,So MW,Oh JS,Lim DH

    更新日期:2020-02-11 00:00:00

  • What is new in lipid-lowering therapies in diabetes?

    abstract::Diabetes can lead to a myriad of microvascular and macrovascular complications - with the leading cause of mortality in diabetes being cardiovascular disease. Low-density lipoprotein cholesterol, along with non-high-density lipoprotein cholesterol and triglycerides are proven, modifiable risk factors for cardiovascula...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.14291

    authors: Cheung YM,O'Brien R,Ekinci EI

    更新日期:2019-12-01 00:00:00

  • Media reporting of health interventions in New Zealand: a retrospective analysis.

    abstract:AIM:To evaluate New Zealand media articles on their coverage of key issues regarding health interventions and whether it is consistent with available evidence. METHODS:A retrospective analysis was carried out of all articles published in five New Zealand media sources over a 6-week period between 15 October and 26 Nov...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.13936

    authors: Robinson C,Cutfield N,Mottershead J,Sharples K,Richards R,Kingan J,Ledgard C,Liyanage A,McLean J,Nahab F,Stewart F,Strachan S,Tucker K,Zhang Z

    更新日期:2018-08-01 00:00:00

  • Poor access to kidney disease management services in susceptible patient populations in rural Australia is associated with increased aeromedical retrievals for acute renal care.

    abstract:BACKGROUND:Inequalities in access to renal services and acute care for rural and remote populations in Australia have been described but not quantified. AIM:To describe: the coverage of renal disease management services in rural and remote Australia; and the characteristics of patients who had an aeromedical retrieval...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14716

    authors: Gardiner FW,Bishop L,Gale L,Harwood A,Teoh N,Lucas RM,Jones M,Laverty M

    更新日期:2020-08-01 00:00:00

  • Differences in characteristics of men with localised prostate cancer who demonstrate low, intermediate or high prostate-specific antigen velocity.

    abstract:BACKGROUND:Current diagnostic tools are inadequate for reliable prediction of prostate cancer (PCa) aggressiveness in patients with localised disease. This results in many patients being exposed to potentially unnecessary invasive treatment and its associated morbidities. In order to develop appropriate treatment strat...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2011.02473.x

    authors: Algotar AM,Thompson PA,Ranger-Moore J,Stratton MS,Hsu CH,Ahmann FR,Nagle RB,Stratton SP

    更新日期:2012-04-01 00:00:00

  • 'Is she experiencing any pain?': disability and the physician-patient relationship.

    abstract::In this essay, I reflect on my experience as a multiple sclerosis patient in order to identify some of the unique challenges that chronic disability poses in the physician-patient relationship. I suggest that it is important to broaden the goals of the clinical encounter to incorporate personal (as opposed to simply b...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2004.00700.x

    authors: Toombs SK

    更新日期:2004-11-01 00:00:00

  • Treatment of patients with Waldenström macroglobulinaemia: clinical practice guidelines from the Myeloma Foundation of Australia Medical and Scientific Advisory Group.

    abstract::Waldenström macroglobulinaemia (WM) is an indolent B-cell malignancy characterised by the presence of immunoglobulin M (IgM) paraprotein and bone marrow infiltration by clonal small B lymphocytes, plasmacytoid lymphocytes and plasma cells. The symptoms of WM are protean, often follow an asymptomatic phase and may incl...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13311

    authors: Talaulikar D,Tam CS,Joshua D,Ho JP,Szer J,Quach H,Spencer A,Harrison S,Mollee P,Roberts AW,Horvath N,Lee C,Zannettino A,Brown R,Augustson B,Jaksic W,Gibson J,Kalff A,Johnston A,Trotman J,Kalro A,Grigoriadis G,

    更新日期:2017-01-01 00:00:00

  • Focus on systemic lupus erythematosus in indigenous Australians: towards a better understanding of autoimmune diseases.

    abstract::The incidence and prevalence of autoimmune diseases such as rheumatoid arthritis, primary Sjögren syndrome, scleroderma and systemic lupus erythematosus (SLE) varies with geography and ethnicity. For example, SLE is reported to be more common in populations such as African-Caribbeans and Indigenous Australians (IA). A...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/imj.12039

    authors: Vincent FB,Bourke P,Morand EF,Mackay F,Bossingham D

    更新日期:2013-03-01 00:00:00

  • Preventing healthcare-associated infection: risks, healthcare systems and behaviour.

    abstract::More than 177 000 potentially preventable healthcare-associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other h...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,评审

    doi:10.1111/j.1445-5994.2009.02004.x

    authors: Ferguson JK

    更新日期:2009-09-01 00:00:00

  • Clinical audit: virological and immunological response to combination antiretroviral therapy in HIV patients at a Sydney sexual health clinic.

    abstract:AIM:Bigge Park Centre (BPC) is a sexual health clinic located in a socially disadvantaged area in Southwest Sydney. This served as a retrospective clinical audit, documenting patient demographics, identifying factors associated with virological, immunological and discordant responses, evaluating the centre's ability in...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2009.01983.x

    authors: Hsu DC,Quin JW

    更新日期:2010-04-01 00:00:00

  • Complicated skin and soft tissue infections in remote indigenous communities.

    abstract::The burden and consequences of skin infections for remote living indigenous people are high. While skin infections are recognised as an antecedent to conditions such as acute rheumatic fever in children, data are limited concerning skin infection complications such as cellulitis, abscesses and osteomyelitis in older c...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14858

    authors: Thomas L,Bowen AC,Tong SYC

    更新日期:2020-06-01 00:00:00

  • Nephrotoxic effects of iodixanol and iopromide in patients with abnormal renal function receiving N-acetylcysteine and hydration before coronary angiography and intervention: a randomized trial.

    abstract:BACKGROUND:The use of contrast agents during coronary intervention can result in nephropathy, particularly in patients with renal dysfunction. We aimed to determine whether the use of iso-osmolar iodixanol is less nephrotoxic than that of low-osmolar iopromide when patients are adequately prehydrated and have received ...

    journal_title:Internal medicine journal

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1111/j.1445-5994.2008.01675.x

    authors: Juergens CP,Winter JP,Nguyen-Do P,Lo S,French JK,Hallani H,Fernandes C,Jepson N,Leung DY

    更新日期:2009-01-01 00:00:00

  • Lipid-lowering therapy use and achievement of cholesterol targets in an Australian diabetes clinic.

    abstract::We documented temporal changes in the use of lipid-lowering medications and achievement of cholesterol targets in an Australian diabetes clinic. The number of patients using lipid-lowering therapy for primary or secondary cardiovascular prevention increased from 6 to 69% between 1993-1995 and 2014-2016, which correspo...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13691

    authors: Kiburg KV,Ward GM,O'Neal DN,MacIsaac RJ

    更新日期:2018-02-01 00:00:00

  • Urgent liver transplantation for acute liver failure due to parvovirus B19 infection complicated by primary Epstein-Barr virus and cytomegalovirus infections and aplastic anaemia.

    abstract::An 11-year-old boy presented with hepatic failure secondary to parvovirus B19 infection, requiring urgent liver transplantation. His recovery was complicated by primary Epstein-Barr virus and cytomegalovirus infections. He subsequently developed aplastic anaemia that has been refractory to antithymocyte globulin and c...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2006.01293.x

    authors: So K,Macquillan G,Garas G,Delriviere L,Mitchell A,Speers D,Mews C,Augustson B,de Boer WB,Baker D,Jeffrey GP

    更新日期:2007-03-01 00:00:00

  • Does a 'code stroke' rapid access protocol decrease door-to-needle time for thrombolysis?

    abstract:BACKGROUND:Timely administration of intravenous tissue plasminogen activator (IVtPA) for acute ischaemic stroke is associated with better clinical outcomes. Therefore, a coordinated hospital system of acute clinical assessment and neuroimaging will likely avoid delays in IV-tPA administration. AIM:In July 2007, we imp...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/j.1445-5994.2011.02709.x

    authors: Tai YJ,Weir L,Hand P,Davis S,Yan B

    更新日期:2012-12-01 00:00:00

  • Malignancy screening in autoimmune myositis among Australian rheumatologists.

    abstract:BACKGROUND:The international literature advocates for cancer screening in newly diagnosed patients with autoimmune myositis; however, there is no widely accepted consensus or guideline to outline the optimal cancer screening strategy and the evidence is currently insufficient to support any recommendation. AIM:Our stu...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.13556

    authors: Dutton K,Soden M

    更新日期:2017-12-01 00:00:00

  • Taking the pulse of Timor-Leste's cardiac needs: a 10-year descriptive time-trend analysis.

    abstract:BACKGROUND:Timor-Leste is one of the poorest countries in the world. The East Timor Hearts Fund is a charitable organisation involving Australian cardiologists providing outreach screening and access to cardiac interventions. AIMS:To assess ten years of clinical volume, demographics and patient outcomes. Our intention...

    journal_title:Internal medicine journal

    pub_type: 杂志文章

    doi:10.1111/imj.14411

    authors: Paratz ED,Mock N,Gutman SJ,Horton A,Creati L,Appelbe A,Eggleton S,Kushwaha V,da Silva Almeida IT,Monteiro A,Bayley N

    更新日期:2020-07-01 00:00:00

  • Prospective study of treatment with selective internal radiation therapy spheres in patients with unresectable primary or secondary hepatic malignancies.

    abstract:AIM:To prospectively evaluate the efficacy and safety of Selective Internal Radiation (SIR) Spheres (Sirtex Medical, Sydney, NSW, Australia) in patients with unresectable primary or secondary hepatic malignancies. METHODS:We report our experience of SIR sphere therapy at three Australian centres. Patients with previou...

    journal_title:Internal medicine journal

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1111/j.1445-5994.2005.00789.x

    authors: Lim L,Gibbs P,Yip D,Shapiro JD,Dowling R,Smith D,Little A,Bailey W,Liechtenstein M

    更新日期:2005-04-01 00:00:00