Effects of Rituximab on Atherosclerotic Biomarkers in Kidney Transplant Recipients

Introduction. Cardiovascular disease is the leading cause of mortality in kidney transplantrecipients. Rituximab is widely used in kidney transplantation for a variety of situations,and rituximab may inhibit some cytokines and antibodies that may play an active role in theatherosclerotic process. The aim of the study was to evaluate the efficacy of rituximab onatherosclerosis biomarkers in kidney transplant recipients.Methods. All patients, 18 years of age and older, who underwent kidney transplantationand received at least 1 dose of 375 mg/m2 rituximab were considered for participation inthis study. The primary study endpoint was the development of cardiovascular diseasesafter rituximab therapy. The secondary endpoint was the onset of cytomegalovirus (CMV)disease or biopsy-confirmed BK virus nephropathy. In addition, comparison ofatherosclerosis biomarkers was performed between study and control groups.Results. There were no cardiovascular events observed during follow up. Only 8 patientsin the study group suffered from CMV disease during follow up. Serum interleukin 10levels were significantly higher in the rituximab group compared with the control group,although antieoxidized low-density lipoprotein levels were lower in the rituximab groupcompared with the control group, though this did not achieve statistical significance.Discussion. Rituximab treatment may increase the risk of CMV reactivation anddecrease lymphocyte counts and interleukin 10 levels; however, significant decreases in allatherosclerotic-related biomarkers have not been shown in our study