Table 1 | Summary of published reports of rituximab use in systemic lupus erythematosus
Study / Number of patients
(nephritis) / Dose of RTX / Concomitant treatments / Remission
(nephritis) / %remission
(nephritis) / B cell
depletion / Anti ds-DNA serology / Relapse
Boletis1 / 10 (10) / 375mg/m2
weekly x4 / MMF, GC / 7/10 CR
1/10 PR
(8/10) / 80 (80) / 9/10 / Statistically significant decrease reported / NR
Catapano,2Smith3 / 31 (11) / 375mg/m2
weekly x4
or 1g every
other week x2 / CYC, GC, MMF, AZA / 17/31 CR
10/31 PR
(10/11) / 87.1 (90.9) / 30/31 / Statistically significant decrease reported at 24 months / 18/27 (median11 months)
Gottenberg4 / 13 (4) / 375mg/m2
every 4
weeks x1–4 / NR / 7/13 CR
2/13 PR
(2/4) / 69.2 (50) / NR / 2/13 decrease, 2/13 increase, 4/13 negative, 3/13 no change, 2/13 no data / 2/9(9,15 months)
Leandro5 / 24 (17) / 0.5–1g every
other week x2 / CYC, GC / 24/24
(17/17)
Improved / NR / 23/24 / Statistically significant decrease reported / 7/24
(timing NR)
Li6 / 19 (19) / 1g every
other week x2 / CYC, GC / 4/19 CR
11/19 PR
(15/19) / 78.9 (78.9) / 18/19 / Statistically significant decrease reported / NR
Linholm7 / 31 (17) / 375mg/m2
weekly x4 / CYC, MMF / NR
(11/17) / NR (64.7) / 31/31 / Statistically significant decrease reported / 4/11 (20, 20, 22, 26 months)
Looney8 / 18 (6) / 100 mg/m2 x1 or
375mg/m2 x1 or
375mg/m2
weekly x4 / AZA, MTX, GC, HCQ / 13/18
Improved
(4/6) / NR / 11/17 / Nosignificant change reported / NR
Lu9 / 46 (33) / 1g every
other week x2 / NR / 19/45 CR
21/45 PR
(NR) / 88.9 (NR) / 45/46 / Statistically significant decrease reported / NR
Melander10 / 20 (20) / 375mg/m2
weekly x4 / GC, CYC, MMF / 7/20 CR
5/20 PR
(12/20) / 60 (60) / 12/17 / 7/17 anti-dsDNA antibodies disappeared / NR
Pepper (reference 8 in main article) / 18 (18) / 1g every
other week x2 / MMF, GC / 6/18 CR
8/18 PR
(14/18) / 77.8 (77.8) / 10/18 / NR but only 11had elevated levels at entry / 2/14 (12 months)
Sfikakis11 / 10 (10) / 375mg/m2
weekly x4 / GC / 5/10 CR
3/10 PR
(8/10) / 80 (80) / 9/10 / Statistically significant decrease reported / 3/8 (5,5,8 months)
Vigna-Perez12 / 22 (22) / 0.5–1g every
other week x2 / MMF, MTX, GC, AZA / 5/22 CR
7/22 PR
18/22 improved (12/22) / 54.5 (54.5) / 20/22 / Nosignificant change reported / NR
Abbreviations: RTX, rituximab; MMF, mycophenolate mofetil; GC, glucocorticoids; CYC, cyclophosphamide; AZA, azathioprine; HCQ, hydroxychloroquine; MTX, methotrexate; NR, not reported.

1.Boletis, J.N. et al.Rituximab and mycophenolate mofetil for relapsing proliferative lupus nephritis: a long-term prospective study. Nephrol. Dial. Transplant.24, 2157–2160 (2009).

2.Catapano, F., Chaudhry, A.N., Jones, R.B., Smith, K.G. & Jayne, D.R. Long-term efficacy and safety of rituximab in refractory and relapsing systemic lupus erythematosus. Nephrol. Dial. Transplant.doi:10.1093/ndt/gfq256.

3.Smith, K.G., Jones, R.B., Burns, S.M. & Jayne, D.R. Long-term comparison of rituximab treatment for refractory systemic lupus erythematosus and vasculitis: remission, relapse, and re-treatment. Arthritis Rheum.54, 2970–2982 (2006).

4.Gottenberg, J.E. et al. Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases. Ann. Rheum. Dis.64, 913–920 (2005).

5.Leandro, M.J., Cambridge, G., Edwards, J.C., Ehrenstein, M.R. & Isenberg, D.A. B-cell depletion in the treatment of patients with systemic lupus erythematosus: a longitudinal analysis of 24 patients. Rheumatology (Oxford)44, 1542–1545 (2005).

6.Li, E.K. et al. Is combination rituximab with cyclophosphamide better than rituximab alone in the treatment of lupus nephritis? Rheumatology (Oxford)48, 892–898 (2009).

7.Lindholm, C. et al. Longterm clinical and immunological effects of anti-CD20 treatment in patients with refractory systemic lupus erythematosus. J. Rheumatol.35, 826–833 (2008).

8.Looney, R.J. et al. B cell depletion as a novel treatment for systemic lupus erythematosus: a phase I/II dose-escalation trial of rituximab. Arthritis Rheum.50, 2580–2589 (2004).

9.Lu, T.Y. et al. A retrospective seven-year analysis of the use of B cell depletion therapy in systemic lupus erythematosus at UniversityCollegeLondonHospital: the first fifty patients. Arthritis Rheum.61, 482–487 (2009).

10.Melander, C. et al. Rituximab in severe lupus nephritis: early B-cell depletion affects long-term renal outcome. Clin. J. Am. Soc. Nephrol.4, 579–587 (2009).

11.Sfikakis, P.P. et al. Remission of proliferative lupus nephritis following B cell depletion therapy is preceded by down-regulation of the T cell costimulatory molecule CD40 ligand: an open-label trial. Arthritis Rheum.52, 501–513 (2005).

12.Vigna-Perez, M. et al. Clinical and immunological effects of Rituximab in patients with lupus nephritis refractory to conventional therapy: a pilot study. Arthritis Res. Ther.8, R83 (2006).

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