Sara Barmettler, United States of America

Massachusetts General Hospital Allergy and Immunology

Presenter of 1 Presentation

Poster Display Therapy

RITUXIMAB USE IN THE UNITED STATES IMMUNODEFICIENCY NETWORK (USIDNET) DATABASE

Lecture Time
10:01 - 10:02
Room
Poster Area
Date
20.09.2019, Friday
Session Time
10:00 - 17:00
Board Number
157
Presentation Topic
Therapy

Abstract

Background and Aims

Rituximab is a chimeric anti-CD20 monoclonal antibody used for a variety of clinical indications. Many patients with primary immunodeficiency (PID) require rituximab for autoimmune and/or lymphoproliferative disease. The prevalence and indications for rituximab use not well-characterized. We sought to better understand the use and effect of rituximab in PID patients.

Methods

The United States Immunodeficiency Network (USIDNET) Database was queried for patients receiving rituximab. Patient demographics, underlying primary immunodeficiency, indication for rituximab, infectious complications, effectiveness and adverse effects were evaluated.

Results

We identified 200 patients who had received rituximab in the USIDNET Database. Most were male (62%), with a median age of 24. The majority of patients were Caucasian (74%). The most common underlying immunodeficiencies included common variable immunodeficiency (n=78), hemophagocytic lymphohistiocytosis (n=22), immune dysregulation (n=18), and severe combined immunodeficiency (n=18). The primary indications for rituximab included idiopathic thrombocytopenic purpura (n=36), EBV infection (n=24), lymphoma (n=23), interstitial lung disease (n=22), and autoimmune hemolytic anemia (n=14). Infectious complications were reported in 130/200 (65%) of the patients. Rituximab was physician reported as being effective in 84/98 (86%) patients. Rituximab was well tolerated, with no adverse reactions described by physician report in 34/49 (69%) of patients.

Conclusions

Many PID patients require biologics including rituximab for autoimmune and lymphoproliferative disease including autoimmune cytopenias, viral infections, and malignancy. While many PID patients require repeated courses of rituximab or other immunomodulators for immune dysregulation including autoimmunity and lymphoproliferation, rituximab was reported as being well tolerated and effective.

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