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Reumatol Clin. 2018 Dec 3. pii: S1699-258X(18)30192-X. doi: 10.1016/j.reuma.2018.08.012. [Epub ahead of print]

Effectiveness and Safety of Rituximab in Systemic Lupus Erythematosus: A Case Series Describing the Experience of 2 Centers.

[Article in English, Spanish]

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Universitat Pompeu Fabra, Universitat Autònoma de Barcelona, Barcelona, España.
Servicio de Reumatología, Hospital del Mar/Parc de Salut-Mar/IMIM, Barcelona, España.
Servicio de Reumatología, Hospital del Mar/Parc de Salut-Mar/IMIM, Barcelona, España. Electronic address:
Servicio de Reumatología, Hospital General de Cataluña, Barcelona, España.
Servicio de Reumatología, Hospital Comarcal Alt Penedés, Villafranca del Penedés, Barcelona, España.



Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organs and systems. B cells have a critical role in the pathogenesis of SLE. Rituximab (RTX) is a drug composed of chimeric monoclonal antibodies against the CD20 protein, producing a depletion of B lymphocytes.


To analyze the effectiveness and safety of RTX in patients with SLE in clinical practice.


Collection of retrospective variables of the medical records of 20 patients with SLE treated with RTX in 2hospitals (Hospital de la Santa Creu i Sant Pau, and Hospital del Mar, in Barcelona, Spain). We evaluated demographic, clinical, serological and treatment variables.


There was a statistically significant association in the following variables collected in the study before and after treatment: there was a decrease in the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (P<.001), erythrocyte sedimentation rate (P=.017), use of glucocorticoids (P=.025) and IgM values (P=.031), as well as an increase in the C4 values (P=.014) after treatment with RTX. A patient with SLE, antiphospholipid syndrome, complex comorbidity and multiorgan lupus involvement died after developing a septic process, months after receiving a single treatment cycle with RTX.


Although RTX currently has no official indication approved for SLE, our data suggest that it may be effective in reducing the activity of the disease and as a steroid-sparing agent, with an acceptable safety profile. However, larger follow-up periods with a greater number of patients are needed to solve the remaining doubts about the use of RTX in SLE.


Autoimmune diseases; B-lymphocytes; Efectividad; Effectiveness; Enfermedades autoinmunes; Linfocitos B; Lupus eritematoso sistémico; Rituximab; Safety; Seguridad; Systemic lupus erythematosus

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