ArticleACR open rheumatology2025
Safety and Effectiveness of Combination Rituximab and Cyclophosphamide Therapy for Treating Pediatric Patients With Severe Manifestations of Rheumatic Disease.
Article in ACR open rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Case Report: Treatment of refractory lung disease in systemic juvenile idiopathic arthritis with cyclophosphamide and rituximab combination therapy.Frontiers in immunology · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveCurrent practice guidelines recommend the use of either rituximab (RTX) or cyclophosphamide (CYC) for the treatment of severe manifestations of systemic vasculitis or connective tissue disease. Few studies have evaluated safety and efficacy outcomes of combination therapy with RTX and CYC. We undertook this study to evaluate outcomes in the first 12 months of RTX/CYC combination therapy in pediatric patients with rheumatic disease.
methodsPatients who received combination RTX/CYC therapy for a rheumatic disease between January 2020 and February 2023 at a single center were included. The primary outcomes of interest were death and infection requiring hospitalization within 12 months of combination therapy. Secondary outcomes included change in serologic lupus disease activity markers and glucocorticoid (GC) dose, flare in disease activity, infusion reactions, and incident hypogammaglobulinemia.
resultsEighty-nine pediatric patients received combination RTX/CYC therapy for a rheumatic disease. There were no reported deaths; eight patients (8.9%) were hospitalized for infection. The mean prednisone-equivalent daily dose significantly decreased by the end of the follow-up period (P < 0.0001), and 54 patients (62%) were able to discontinue GCs. Patients with systemic lupus erythematosus demonstrated improvements across all serologic disease activity markers (P < 0.0001). Six patients (6.7%) experienced flare of disease, 11 patients (12%) experienced infusion reactions, and 26 patients (31%) experienced incident hypogammaglobinemia.
conclusionCombination therapy with RTX and CYC can be safely administered to children with rheumatic diseases. Risk of serious adverse events and disease flare is uncommon, allowing for effective treatment with decreased GC burden. Prospective controlled trials comparing combination therapy to standard therapy are needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.