Experience with Use of Rituximab in Different Connective Tissue Diseases in Bangladesh

Aim of the study was to assess the tolerance and efficacy of rituximab in patients with different autoimmune diseases in a Bangladeshi population. This is an observational study or an open label clinical trial and was conducted in the department of Rheumatology of BSMMU, Dhaka, Bangladesh from September 2008 to September 2010. Total 20 patients were enrolled and three were lost to follow up. Among them, eleven were suffering from Rheumatoid arthritis (RA), three from Systemic lupus erythematosus (SLE) and three from Primary Sjogren's syndrome (PSS). All were unresponsive to first line recommended drugs available in Bangladesh. They were treated with Rituximab and were followed up to 24 weeks from the administration of Rituximab. Among the twenty patients eleven RA patients, three SLE patients and three PSS patients were completed the follow up. They were followed up for 6 months. Five (5) patients had suffered from adverse events and one of them died of pneumonia. All Rituximab treated RA patient achieved ACR 20 response (100.0%), one SLE patient achieved complete remission (SLEDAI 0-2) and another two achieved partial remission. Among the patients of PSS two achieved partial remission and another one achieved 45.1% improvement from the baseline. Treatment of different connective tissue diseases is sometimes very challenging. Use of Rituximab to treat various refractory autoimmune diseases showed good tolerance and short-term clinical efficacy in Bangladesh.