{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:12:04Z","timestamp":1777929124099,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002384"],"award-info":[{"award-number":["UL1TR002384"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To study the risk of lupus nephritis flare (LNF) or severe lupus flare (SLF) as a function of B cell count kinetics in lupus nephritis (LN) patients after they achieve at least a partial renal response (PRR) with induction treatment that includes rituximab (RTX) and\/or belimumab (BLM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of a cohort of 19 patients with severe LN that received a B cell agent (BCA), RTX and\/or BLM, as part of an initial treatment regimen for an LN flare and had subsequent CD19+ B cell measurements in peripheral blood. We then characterized the follow-up periods, after B cell depressions occurred and PRR were achieved, by the corresponding trajectories of B cell counts (BCC). Time periods with sustained low BCC were type 1 (T1) episodes, while those with repletion of BCC&gt;100 cells\/\u03bcL were called type 2 (T2) episodes. Time periods with rapid BCC repletion, defined as &gt;50 cells\/\u03bcL in \u22646\u00a0months, were called T2b episodes. Corresponding C3, C4, and anti-dsDNA levels were recorded for each episode. The time from PRR until an event, either a LNF or SLF, or to censoring, either at the end of the study period or the end of available patient follow-up, was assessed for each episode type. Kaplan-Meier survival analysis was used to compare time to flare between T1 and T2 episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 26 episodes of B cell depression. Seventeen (65%) were T1 and 9 (35%) were T2. Compared to T1 episodes, T2 episodes were 9.0 times more likely to result in flare over the follow-up period (hazard ratio (HR) = 9.0, 95% CI for HR = 2.2-36.7); this risk was even larger for T2b vs T1 episodes. Median BCC was 14 cells\/\u03bcL in T1 and 160 cells\/\u03bcL in T2 episodes. Both C3 and C4 levels significantly increased over the duration of the episode in T1 episodes only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sustained low BCC was associated with prolonged serologic and clinical response, whereas repletion, and particularly rapid repletion, of B cells after treatment with BCA was associated with subsequent disease flare.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033241260283","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T04:23:23Z","timestamp":1718079803000},"page":"938-947","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Sustained depression of B cell counts in lupus nephritis after treatment with rituximab and\/or belimumab is associated with fewer disease flares"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9701-7249","authenticated-orcid":false,"given":"Diane","family":"Zisa","sequence":"first","affiliation":[{"name":"Columbia University Irving Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Zhang-Sun","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J","family":"Christos","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2781-0065","authenticated-orcid":false,"given":"Kyriakos A","family":"Kirou","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"},{"name":"Weill Cornell Medicine, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"bibr1-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.39594"},{"key":"bibr2-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.10142"},{"key":"bibr3-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-016-0562-3"},{"key":"bibr4-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1186\/ar3908"},{"key":"bibr5-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.27189"},{"key":"bibr6-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1177\/15563316221142846"},{"key":"bibr7-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61354-2"},{"key":"bibr8-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.30613"},{"key":"bibr9-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001180"},{"key":"bibr10-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.27233"},{"key":"bibr11-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.34359"},{"key":"bibr12-09612033241260283","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01070118"},{"key":"bibr13-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-220920"},{"key":"bibr14-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab827"},{"key":"bibr15-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211191"},{"key":"bibr16-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-216924"},{"key":"bibr17-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02017-5"},{"key":"bibr18-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.30466"},{"key":"bibr19-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.044487"},{"key":"bibr20-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-025687"},{"key":"bibr21-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.41466"},{"key":"bibr22-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2018.03.003"},{"key":"bibr23-09612033241260283","doi-asserted-by":"publisher","DOI":"10.7326\/M21-2078"},{"key":"bibr24-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1002\/art.40930"},{"key":"bibr25-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.11.023"},{"key":"bibr26-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00578-X"},{"key":"bibr27-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014460"},{"key":"bibr28-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa051135"},{"key":"bibr29-09612033241260283","unstructured":"Zisa D, Kirou KA. Relapsing lupus nephritis and cutaneous vasculitis: a race to contain B cells, 2020. https:\/\/www.hss.edu\/conditions_complexcase-relapsing-lupus-nephritis-and-cutaneous-vasculitis.asp (accessed 4 September 2023)."},{"key":"bibr30-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker526"},{"key":"bibr31-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1016\/s1567-5769(02)00210-2"},{"key":"bibr32-09612033241260283","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0603-8"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033241260283","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033241260283","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033241260283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:28:03Z","timestamp":1777678083000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033241260283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,11]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1177\/09612033241260283"],"URL":"https:\/\/doi.org\/10.1177\/09612033241260283","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,11]]}}}