B cell repopulation trajectory after rituximab treatment in autoimmune diseases: a longitudinal observational study.

Abstract

To investigate B-cell repopulation trajectory and the associated factors in patients with autoimmune diseases (AIDs) who underwent rituximab (RTX) treatment. This is a retrospective study in a large tertiary medical center. Kaplan-Meier analysis and Cox regression were used to investigate factors associated with B-cell repopulation. Latent class trajectory modeling (LCTM) was employed to identify distinct B-cell repopulation trajectory longitudinally. A total of 224 patients were included, with a cumulative follow-up time of 193.6 person-years. Patients with antineutrophil cytoplasm antibody-associated vasculitis (AAV), connective tissue disease, and IgG4-related disease exhibited significant differences in B-cell repopulation time (p = 0.0055 by log-rank test). Multivariate Cox regression identified that higher levels of IgA (HR 1.21, 95%CI 1.01-1.45, p = 0.040) and concurrent glucocorticoid use (HR = 0.37,95%CI 0.20-0.67, p = 0.001) were associated with B-cell repopulation. The cluster showing prolonged B-cell depletion, identified by LCTM, had lower proportions of male (27% vs. 48.5%, p = 0.033), smoke history (17.6% vs. 38.7%, p = 0.025), higher proportions of AAV (44.3% vs. 15.2%, p = 0.004), RTX dose (p = 0.042), history of cyclophosphamide use (70.4% vs. 48.5%, p = 0.003), meanwhile glucocorticoid use (94.8% vs. 72.7%, p = 0.001). The trajectory of B-cell repopulation after RTX infusion in AIDs was heterogeneous. Certain factors were associated with B-cell repopulation, and a specific cluster of patients demonstrated prolonged B-cell depletion after RTX treatment.

• Authors: Yuxue Nie, Jingna Li, Di Wu, Yunjiao Yang, Li Zhang, Wei Bai, Nan Jiang, Lin Qiao, Can Huang, Shuang Zhou, Xinping Tian, Mengtao Li, Xiaofeng Zeng, Linyi Peng, Wen Zhang
• Journal: Clinical and experimental medicine (Clin Exp Med) Vol. 23 Issue 8 Pg. 4787-4795 (Dec 2023) ISSN: 1591-9528 [Electronic] Italy
• PMID: 37751119 (Publication Type: Observational Study, Journal Article)
• Copyright: © 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.

Chemical References

• Rituximab
• Glucocorticoids

Topics

• Humans
• Male
• Rituximab (therapeutic use)
• Retrospective Studies
• Glucocorticoids (therapeutic use)
• Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis (drug therapy)
• Autoimmune Diseases (drug therapy)
• Treatment Outcome