Use of rituximab in lupus

Bottom Line: There is only limited evidence available on effectiveness of rituximab in SLE.  This is some evidence to suggest African-American and Hispanic patients with SLE may respond differently to rituximab.  Currently, rituximab is used mainly in patients who are refractory to other medications.

Summary: Systemic lupus erythematosus (SLE).  In:  DynaMed.
Multiple case series demonstrated reduction in disease activity in patients on rituximab compared to placebo.  An RCT of 257 patients [Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial.  Arthritis Rheum 2010 Jan;62(1):222] with no explanation of allocation concealment evaluated rituximab (1,000 mg IV given in 2 doses 14 days apart) v. placebo.  Outcome was the score on the BILAG (British Isles Lupus Assessment Group) as measure of disease activity. RESULTSFigure 2 (p. 226) summarizes response rates for placebo v. rituximab.  No significant difference in response rates between the two groups.  However, a sub-analysis suggested a difference in response rates for African-American and Hispanic patients.

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