Albert [35] |
1× hypotension/bradycardia/fever; 1× serum sickness after 2nd dose, high HACA; 1× ?lupus cebritis, ?meningitis 8wks after RTX |
None allowed 1 month prior to RTX; 100 mg MP before infusions to reduce risk infusion reaction |
Galarza [39] |
4 patients had adverse effects |
MP; CYC stopped in all; MMF continued in 6 patients |
Gottenberg [53] |
2× neutropenia, 2× serum sickness |
2 patients AZA, 1 HCQ, 2 MP, 1 CIC, 1 CYC |
Gillis [18] |
1× herpes zoster, 1× UTI |
Steroids and existing (CYC, AZA, MMF) |
Gunnarsson [37] |
1× UTI, 1× neutropenic fever, 1× herpes zoster, 1× photosensitive eruption |
CYC with 1st and last RTX; prednisolone (tapered) |
Hernandez [56] |
1× terminal renal failure and colitis |
CYC, steroids + others “as necessary” |
Lindholm [25] |
1× osteitis in the jaw (possibly present before RTX), 1× serum sickness after 3rd RTX, 1× neutropenia and pseudomonas sepsis 2 months after last RTX, 1 patient died of pulmonary infection 23 months after RTX, 1 patinet died of dilated cardiomyopathy 18 months after RTX |
RTX added to regimen (CYC/MMF), maintained until remission |
Looney [13] |
1 mild infusion reaction; 1× herpes zoster 3 weeks after rituximab |
Excluded CYC patients, others allowed |
Lu [24] |
1× serum sickness-like reaction (responded to steroids), 1× SLE-pericarditis–DIED (BCs repopulated), 1× pneumococcal pneumonia/sepsis, 1× hyponatraemia and seizure hrs after CYC, 1× ARDS after CYC–DIED |
CYC 750 mg, MP 250 mg IVI to reduce risk infusion reaction |
LUNAR [29] |
overall incidence comparable between placebo and RTX; differences in rates of leukopenia (12.3% vs 4.2%), neutropenia (5.5% vs 1.4%) and hypotension (11% vs 4.2%) |
MMF and corticosteroids; retreated at 6/12 with same |
Melander [58] |
5 infections, 4 moderate neutropenias |
3 also got CYC |
Merrill [30] |
37.9% of the RTX group and 36.4% of the placebo had adverse effects (RTX: 4× serum sickness, more neutropenia) |
RTX added to existing regimen; steroids tapered down |
Shahrir [40] |
2× anaphylaxis, both failed to have the study’s incorporated pre-medication |
RTX and MP added to existing regimen |
Smith [31] |
Infusion reactions comon (resolved with hydrocortisone and antihistamine), 1× serum sickness after 3rd RTX dose (responded to MP), low rates of infection (2× pneumonia, 1× UTI, 1× abscess) |
500 mg CYC with 1st RTX infusion, added to existing regimen (AZA or MMF) |
Tamimoto [19] |
1× infusion reaction; 5× bacterial infection; 1× candidiasis; 1 died renal failure from disease progression |
All on prednisolone; 2 CIC; 1 CYC |
Tanaka [34] |
bacterial infections—1× pneumonia, 1× enteritis, 2× UTI, cyctitis, URTIs |
Prednisolone only; others not allowed |
Tokunaga [49] |
1 herpes zoster in patient with IgG drop |
Prednisolone; 1 on CYC at outset, but stopped during study |
Tokunaga [38] |
pneumonia ×2, herpes zoster, infected ulcer |
Variable pre-study, stopped during study; low-dose steroid throughout |
Vigna-Perez [15] |
1 invasive histocytosis (died) |
RTX added to regimen |