在儿童频繁复发和类固醇依赖性性综合征中使用奥比努祖马布
Claire Dossier1, Stéphanie Bonneric1, Véronique Baudouin1
1Pediatric Nephrology Department, Robert-Debré Hospital, APHP, Paris, France.
Clinical journal of the American Society of Nephrology : CJASN
|September 7, 2023
概括
低剂量奥比努祖马布有效地消耗B细胞,并诱导患有脏综合征的儿童持续缓解,即使是那些对rituximab耐药的儿童. 建议监测血液细胞计数和免疫球蛋白水平.
科学领域:
- 儿科脏病学 儿科脏病学
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 瑞图西马布诱导的B细胞枯竭为性综合征提供了缓解,但在B细胞恢复时会出现复发.
- 一些患者表现出对rituximab的耐药性,需要替代治疗.
- 奥比努图祖马布是一种较新的抗CD20抗体,在自身免疫性疾病中表现有前途.
研究的目的:
- 评估低剂量奥比努祖马布在患有类固醇依赖症或经常复发性性综合征的儿童的疗效和安全性.
- 评估在Rituximab治疗后耐药或复发的患者中Obinutuzumab的有效性.
主要方法:
- 对41名儿童进行了回顾性分析,这些儿童接受了单次300 mg/1.73 m2的奥比努图祖马布输液.
- 治疗发生在2018年4月至2020年12月期间,用于抗瑞思基马布或复发性性综合征.
- 口服免疫抑制剂在奥比努祖祖马布输注后两个月内停止使用.
主要成果:
- 所有患者的B细胞完全枯竭,平均持续时间为8.3个月.
- 持续缓解率在12个月后为92%,在24个月后为68%.
- 观察到轻度输液反应 (12%) 和中性质减退 (21%);IgG水平保持稳定,而IgM水平在治疗后正常化.
结论:
- 低剂量奥比努祖马布是儿科性综合征的有前途的治疗选择,包括对rituximab耐药的病例.
- 奥比努图祖马布的安全性表现良好,与利图西马布相美.
- 在obinutuzumab治疗期间建议监测血液图和免疫球蛋白水平.
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