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Publication Detail
Use of rituximab in systemic lupus erythematosus: a single center experience over 14 years.
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Aguiar R, Araújo C, Martins-Coelho G, Isenberg D
  • Publication date:
    25/04/2016
  • Journal:
    Arthritis care & research
  • Medium:
    Print-Electronic
  • Print ISSN:
    2151-464X
  • Language:
    eng
  • Addresses:
    Rheumatology Department, Centro Hospitalar do Baixo Vouga E.P.E.
Abstract
To describe the clinical outcome and safety of rituximab (RTX) treatment in systemic lupus erythematosus (SLE) patients with severe manifestations or refractory to standard immunosuppressive therapy, treated at a single center.This was a retrospective analysis of all patients with SLE treated with RTX at one center between June 2000 and December 2013. The clinical outcome was assessed by determining BILAG scores, anti dsDNA and C3 levels before and six months after RTX treatment. For safety analysis, adverse events and deaths were recorded.Of a total of 115 patients, 93.9% were female; mean age at diagnosis was 26.39±11.90 years: mean disease duration at first RTX treatment was 91.96±84.80 months. A BILAG score variation of -11.26±11.38 (p<0.001) was recorded six months after first RTX treatment; 40% of patients had a complete response and 27% had a partial response; in 36.5% of patients, C3 levels increased over 25%, and in 33.5% dsDNA levels decreased over 50%. Depletion of CD19+ cells was achieved in 94.0% of patients. Hypogammaglobulinemia was detected in 14.9% of patients, with significant reduction for IgM (p<0.001) and IgG (p=0.001) levels. Severe infections, infusion-related and hypersensitivity reactions occurred in 7%, 3.5% and 2.6% of patients. Of the 115 patients, 62 patients had repeated RTX treatments, with an average number of 1.95±1.17 cycles per patient and a mean interval between infusions of 21.44±20.11 months. At the end of follow-up, 11 patients were deceased; 6 had cardiovascular events.RTX treatment was effective in decreasing disease activity, with low incidence of adverse effects. This article is protected by copyright. All rights reserved.
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