RESEARCH - Rituximab plus cyclophosphamide useful against refractory SLE

[Guest guest]

Rituximab Plus Cyclophosphamide Useful Against Refractory SLE

NEW YORK (Reuters Health) Mar 19 - Treatment with rituximab along with

cyclophosphamide can be helpful in patients with severe and refractory

systemic lupus erythematosus (SLE), Swedish researchers report in the

March issue of ls of the Rheumatic Diseases.

Dr. F. van Vollenhoven and colleagues at Karolinska University

Hospital, Stockholm note that B cell depleting therapy with this

monoclonal antibody, directed against the B cell specific antigen

CD20, has " shown encouraging results in patients with SLE. "

In the present study, 16 female patients who had not responded to

conventional immunosuppressive therapy received weekly infusions of

rituximab for 4 weeks. The first and last infusion was combined with

cyclophosphamide and glucocorticoid.

At 6 months, there was a significant decrease in the SLE Disease

Activity Index, and all but three patients showed clinical improvement

(defined as a 50% reduction in the Index score). Moreover, only one

patient did not respond according to British Isles Lupus Assessment

Group criteria. Remission was achieved in nine patients.

Isotype analysis of anti-dsDNA antibodies revealed preferential

decreases of IgG and IgA, but not IgM, suggesting to the investigators

that " cells producing pathogenic autoantibodies are preferentially

targeted by the treatment. "

The investigators stress that the data should not be extrapolated to

include other SLE patients, but conclude that " for patients with

severe SLE who have failed to respond to conventional treatment, the

combination of rituximab and cyclophosphamide can provide a new

therapeutic alternative. "

Ann Rheum Dis 2008;67:330-334.

http://www.medscape.com/viewarticle/571667

--

Not an MD