Effectiveness and Safety of Rituximab in Systemic Lupus Erythematosus: A Case Series Describing the Experience of 2 Centers.
Autor: Gómez, Vicenç Juan; Carrión-Barberá, Irene; Salman Monte, Tarek Carlos; Acosta, Asunción; Torrente-Segarra, Vicenç; Monfort, Jordi
Publication year: 2020
Reumatologia clinica
issn:2173-5743
doi: 10.1016/j.reuma.2018.08.012
Abstract:
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems. B cells have a critical role in the pathogenesis of SLE. Rituximab (RTX) is a drug composed of chimeric monoclonal antibodies against the CD20 protein, producing a depletion of B lymphocytes. OBJECTIVE: To analyze the effectiveness and safety of RTX in patients with SLE in clinical practice. METHODS: Collection of retrospective variables of the medical records of 20 patients with SLE treated with RTX in 2hospitals (Hospital de la Santa Creu i Sant Pau, and Hospital del Mar, in Barcelona, Spain). We evaluated demographic, clinical, serological and treatment variables. RESULTS: There was a statistically significant association in the following variables collected in the study before and after treatment: there was a decrease in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (P<.001), erythrocyte sedimentation rate (P=.017), use of glucocorticoids (P=.025) and IgM values (P=.031), as well as an increase in the C4 values (P=.014) after treatment with RTX. A patient with SLE, antiphospholipid syndrome, complex comorbidity and multiorgan lupus involvement died after developing a septic process, months after receiving a single treatment cycle with RTX. CONCLUSIONS: Although RTX currently has no official indication approved for SLE, our data suggest that it may be effective in reducing the activity of the disease and as a steroid-sparing agent, with an acceptable safety profile. However, larger follow-up periods with a greater number of patients are needed to solve the remaining doubts about the use of RTX in SLE. Language: spa Rights: Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved. Pmid: 30522941 Tags: Humans; Female; Male; Adult; Middle Aged; Retrospective Studies; Treatment Outcome; Safety; Efectividad; Effectiveness; Lupus eritematoso sistémico; Systemic lupus erythematosus; Rituximab; Autoimmune diseases; B-lymphocytes; Enfermedades autoinmunes; Immunologic Factors/adverse effects/*therapeutic use; Linfocitos B; Lupus Erythematosus, Systemic/*drug therapy; Rituximab/adverse effects/*therapeutic use; Seguridad Link: https://pubmed.ncbi.nlm.nih.gov/30522941/
