ArticleBMC musculoskeletal disorders2014
The effect of rituximab therapy on immunoglobulin levels in patients with multisystem autoimmune disease.
Article in BMC musculoskeletal disorders, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
58 citing papers in PubMed, 145 citations in OpenAlex.
- Infection prophylaxis following anti-CD20 monoclonal antibodies in childhood kidney diseases.Pediatric nephrology (Berlin, Germany) · 2026Review
- Dysregulated IL-6 pathway activity in idiopathic inflammatory myopathies.Arthritis research & therapy · 2026Article
- Navigating primary and secondary immunodeficiency intersections: how to find IEI hidden within SID.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2026Review
- Hypogammaglobulinaemia in patients with ANCA-associated vasculitis treated with rituximab.Frontiers in medicine · 2026Article
- Article
- Rituximab is associated with an increased risk of malaria among adult lymphoma patients in Malawi: a prospective observational cohort.EClinicalMedicine · 2025Article
- Exploring the depths of hypogammaglobulinemia in lymphoid malignancies: Pathophysiology, clinical implications, management options, and future directions.Blood reviews · 2025Review
- Successful treatment of amoxicillin-induced linear IgA bullous dermatosis of childhood with rituximab: A case report and review of the literature.JAAD case reports · 2025Article
- Aging in Granulomatosis with Polyangiitis and Microscopic Polyangiitis: From Pathophysiology to Clinical Management.Drugs & aging · 2025Review
- Elevated Fab glycosylation of autoantibodies maintained during B cell depletion therapy.Scientific reports · 2025Article
- Review
- Opportunities and limitations of B cell depletion approaches in SLE.Nature reviews. Rheumatology · 2025Review
- Article
- B cell subsets reconstitution and immunoglobulin levels in children and adolescents with B non-Hodgkin lymphoma after treatment with single anti CD20 agent dose included in chemotherapeutic protocols: single center experience and review of the literature.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2024Review
- Risk of severe infection associated with immunoglobulin deficiency under rituximab therapy in immune-mediated inflammatory disease.RMD open · 2024Observational
- Advancements and prospects of novel biologicals for myasthenia gravis: toward personalized treatment based on autoantibody specificities.Frontiers in pharmacology · 2024Review
- Long-term surveillance study of rituximab originator treated patients with granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA).Rheumatology advances in practice · 2024Article
- Current Insights Into K-associated Fetal Anemia and Potential Treatment Strategies for Sensitized Pregnancies.Transfusion medicine reviews · 2024Review
- Rituximab-associated hypogammaglobulinemia in children with idiopathic nephrotic syndrome: results of an ESPN survey.Pediatric nephrology (Berlin, Germany) · 2023Article
- Salivary IgA subtypes as novel disease biomarkers in systemic lupus erythematosus.Frontiers in immunology · 2023Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundRituximab is a B cell depleting anti-CD20 monoclonal antibody. CD20 is not expressed on mature plasma cells and accordingly rituximab does not have immediate effects on immunoglobulin levels. However, after rituximab some patients develop hypogammaglobulinaemia.
methodsWe performed a single centre retrospective review of 177 patients with multisystem autoimmune disease receiving rituximab between 2002 and 2010. The incidence, severity and complications of hypogammaglobulinaemia were investigated.
resultsMedian rituximab dose was 6 g (1-20.2) and total follow-up was 8012 patient-months. At first rituximab, the proportion of patients with IgG <6 g/L was 13% and remained stable at 17% at 24 months and 14% at 60 months. Following rituximab, 61/177 patients (34%) had IgG <6 g/L for at least three consecutive months, of whom 7/177 (4%) had IgG <3 g/L. Low immunoglobulin levels were associated with higher glucocorticoid doses during follow up and there was a trend for median IgG levels to fall after ≥ 6 g rituximab. 45/115 (39%) with IgG ≥ 6 g/L versus 26/62 (42%) with IgG <6 g/L experienced severe infections (p=0.750). 6/177 patients (3%) received intravenous immunoglobulin replacement therapy, all with IgG <5 g/L and recurrent infection.
conclusionsIn multi-system autoimmune disease, prior cyclophosphamide exposure and glucocorticoid therapy but not cumulative rituximab dose was associated with an increased incidence of hypogammaglobulinaemia. Severe infections were common but were not associated with immunoglobulin levels. Repeat dose rituximab therapy appears safe with judicious monitoring.
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