J Korean Rheum Assoc.  2005 Dec;12(4):251-262.

Rituximab Treatment for the Patient with Refractory Lupus Nephritis

• Youm JY
• Sung YK
• Uhm WS
• Jun JB
• Yoo DH
• Bae SC

Abstract

OBJECTIVE
To determine preliminary evidence for the safety and efficacy of B lymphocyte depletion therapy in refractory systemic lupus erythematosus (SLE).
METHODS
Four female lupus nephritis patients who had been refractory to steroid and one or more immunosuppressive therapy were treated on an open-label basis. During a 4-week period, each patient received two 500-mg infusions of rituximab and two 750-mg infusions of cyclophosphamide.
RESULTS
Patient 1, 2, and 3 were responded with rituximab treatment with improvements in SLEDAI and laboratory parameters such as C3/C4 and 24 hour urine protein. However, patient 4 had not improved with rituximab. The variation in the level of anti-double-stranded DNA antibody was different in individual patients. No significant adverse events were observed during follow-up.
CONCLUSION
This study provides an evidence for the safety and possible efficacy of B lymphocyte depletion therapy in refractory lupus nephritis. However a further randomized trial is needed to confirm the efficacy and durability of remission.

Keyword

Rituximab; SLE; Lupus nephritis

MeSH Terms

Cyclophosphamide
DNA
Female
Follow-Up Studies
Humans
Lupus Erythematosus, Systemic
Lupus Nephritis*
Lymphocyte Depletion
Rituximab
Cyclophosphamide
DNA