Abstract
Background and aims B-cell-targeted therapies have been promising new treatments for SLE. Herein, we aimed to analyse the effects of Rituximab in lupus patients with involvement of different domains.
Methods This is an analysis of 79 lupus patients treated with rituximab at the rheumatology outpatient clinic. Patient features, previous and concomitant treatments, baseline clinical and serological characteristics, treatment response at 3 and 6 months, number of cycles, flares, infections and infusion reactions were analysed. Disease activity was assessed using SLE disease activity index (SLEDAI) and treatment response was defined according to the system involved.
Results 37 patients received Rituximab for lupus nephritis (LN), 15 for thrombocytopenia and/or autoimmune hemolytic anaemia (AIHA), 12 for arthritis, 7 for vasculitis and 8 for general activity. Majority of the patients received one or two cycles of Rituximab. The reason of further cycles was maintenance in 40.5% of patients, non-remission in 50% and flare in 9.5%. Highest complete response (CR) rate at the 6th month was within the general disease activity group followed by the arthritis group. Comparison of treatment response between classIV and V LN revealed a a significantly higher number of CR in class IV at the 6th month of treatment.
Comparison of SLEDAI score, steroid dose, anti-dsDNA positivity and complement levels between baseline and at the 6th month favoured treatment. There were 9 infusion reactions and 12 infections.
Conclusions Rituximab remains as a therapeutic option, especially in severe and refractory cases. Safety profile is good but infusion reactions may represent a problem.
