Treating severe systemic lupus erythematosus with rituximab. An open study

Recurrent diffuse alveolar haemorrhage in a patient with systemic lupus erythematosus: long-term benefit of rituximab

“…15 RTX has several mechanisms of action, and we know also that the peripheral B cell depletion occurs within days and might have clinical long-term benefits (months); 16 additionally to the number and function of B cell modification, we recognized that rituximab has an action on regulatory T cells. 5 It can explain the benefit of RTX to prevent recurrent DAH. It is not possible to know when our patient will require another course of RTX.…”

“…[1][2][3] Open label studies have reported the benefits of RTX in patients with SLE particularly in severe and refractory disease activity. 4,5 We describe a case of a patient with SLE, cachexia and recurrent DAH (four episodes) and other disease activity symptoms in whom a combination of different drugs including RTX induced low disease activity and no relapses at more than one year of follow-up.…”

Targeting B cells in the pre-phase of systemic autoimmunity globally interferes with autoimmune pathology

“…However, for SLE conflicting results have been observed. While preliminary studies suggested a benefit of B lymphocyte depletion therapy ( Leandro et al., 2002 ; Abud-Mendoza et al., 2009 ; Ramos-Casals et al., 2009 ) the final EXPLORER trial failed to confirm these previous studies and could not detect differences between placebo and rituximab treated patient groups ( Merrill et al., 2010 ). Nonetheless, targeting B cells in earlier phases of disease development such as during the pre-clinical phase of disease, may allow achieving better clinical outcomes.…”

Response to ‘Are steroids required for induction therapy and relapses in lupus nephritis?’ by Abud-Mendoza et al

“…Supporting our data, they were able to curtail their use of glucocorticoids by using Rituximab. It is also encouraging to note their publication in 20093 where they were able to treat other severe manifestations of SLE with Rituximab (in combination with other agents) without having to increase further GC or avoiding GC altogether. These publications add further evidence to the important role rituximab may have in the treatment of SLE and its particular potential for minimising glucocorticoid use.…”