Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
The aim of this study was to determine if there is any relation between ethnicity and outcome in patients with SLE treated with B cell depletion therapy (BCDT).
Methods :
Between June 2000 and December 2011, 102 SLE patients received BCDT in our centre. The mean age was 31 years old. 92,2% were female. 41.2 % of them (42) received at least two cycles. It was administered intravenously, each cycle consisting of: cyclophosphamide 750-1500 mg, methylprednisolone 125-250 mg and rituximab 1 g, on 2 occasions, 2 weeks apart.
In this observational study we reviewed the disease activity assessments at the time of BCDT and six and twelve months later using the British Isles Lupus Assessment Group (BILAG) activity index, and the serological markers C3 and anti-dsDNA antibody levels.
Complete remission (CR) was defined as the loss of all BILAG A or B scores (to a C or D score). Partial remission (PR) was a change from a BILAG A or B score to a C or D score in at least 1 system, but with the persistence of 1 or more A or B scores in another system. No improvement was defined as a BILAG A or B score that remained unchanged after treatment. Worsening was also noted (no improvement and worsening = other, see below).
Results :
In our cohort at the time of the initial BCDT 46 patients (45.1%) were Caucasian (C), 28 (27.4%) Afrocaribbean (AC), 21 (20.6%) Asian (As) and 7 (6.8%) Oriental (O). In the second cycle 13 (31%) were C, 16 (38.1% ) AC, 11 (26.1%) As and 2 (4.8%) O.
There were no statistically significant differences between the ethnic groups in terms of gender, mean age and mean BILAG total score at the time of BCDT.
For our analysis we excluded the Oriental patients because of their small number. We had sufficiently complete data on 80 patients for the analysis.
After the first and second cycle of BCDT the rates of complete remission, partial remission and other outcomes including worsening (CR/PR/other) were as follows:
|
6 months after BCDT 1st cycle
|
12 months after BCDT 1st cycle
|
6 months after BCDT 2nd cycle
|
12 months after BCDT 2nd cycle
|
|
|
C |
37.5%/ 22.5%/ 40% |
37.8%/ 24.3%/ 37.8% |
38.5%/ 7.7%/ 53.8% |
33.3%/ 16.7%/ 50% |
|
AC |
38.1%/ 9.5%/ 52.4% |
45%/ 5%/ 50% |
28.6%/ 28.6%/ 42.9% |
53.9%/ 7.7%/ 38.5% |
|
As |
36.8%/ 15.8%/ 47.4% |
42.1%/ 15.8%/ 42.1% |
33.3%/ 22.2%/ 44.4% |
16.7%/ 33.3%/ 50% |
These differences between the ethnicities were not statistically significant (p>0.05) and there were no significant differences between groups with respect to the number of patients who increased their C3 by 25% from baseline or decreased their anti-dsDNA antibody level by 50% or more.
Conclusion :
Our data suggest that BCDT is equally effective in SLE patients of Caucasian, Afrocaribbean and Asian. However, a larger sample size is recommended to confirm this.
Disclosure:
A. Lois-Iglesias,
None;
J. Ishorari,
None;
D. A. Isenberg,
None.
« Back to 2012 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/ethnicity-and-b-cell-depletion-therapy-in-systemic-lupus-erythematosus/