Use of Rituximab in Systemic Lupus Erythematosus: A Single Center Experience Over 14 Years

Area of Science:

• Rheumatology
• Immunology
• Clinical Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by diverse clinical manifestations.
• Patients with severe or refractory SLE often require advanced therapeutic strategies.
• Rituximab (RTX), a monoclonal antibody targeting CD20-expressing B cells, has emerged as a potential treatment option.

Purpose of the Study:

• To evaluate the clinical outcomes and safety profile of rituximab (RTX) in patients diagnosed with systemic lupus erythematosus (SLE).
• To assess RTX efficacy in patients with severe SLE manifestations or those refractory to standard immunosuppressive therapies.
• To analyze RTX safety, including adverse events and mortality, in a single-center cohort.

Main Methods:

• Retrospective analysis of 115 SLE patients treated with RTX between June 2000 and December 2013.
• Clinical outcomes assessed using British Isles Lupus Assessment Group (BILAG) scores, anti-double-stranded DNA (anti-dsDNA) levels, and C3 complement levels.
• Safety evaluation included recording adverse events, infusion reactions, and mortality data.

Main Results:

• RTX treatment led to a significant decrease in BILAG scores (mean variation -11.26, P < 0.001) at 6 months.
• Positive responses observed: 40% complete response, 27% partial response.
• Biomarker improvements included increased C3 levels in 36.5% and decreased anti-dsDNA levels in 33.5% of patients.
• CD19+ B-cell depletion achieved in 94.0% of patients.
• Adverse events: severe infections (7%), infusion reactions (3.5%), hypersensitivity (2.6%).

Conclusions:

• Rituximab demonstrates significant efficacy in reducing disease activity in SLE patients.
• The treatment is associated with a favorable safety profile, characterized by a low incidence of adverse effects.
• RTX offers a valuable therapeutic option for severe or refractory SLE cases.