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Autoimmune Diseases
Volume 2012 (2012), Article ID 565039, 6 pages
http://dx.doi.org/10.1155/2012/565039
Clinical Study

Multicenter Retrospective Analysis of the Effectiveness and Safety of Rituximab in Korean Patients with Refractory Systemic Lupus Erythematosus

1Division of Rheumatology, Department of Internal Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Guri-si 471-701, Republic of Korea
2Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Republic of Korea
3Division of Rheumatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu 700-705, Republic of Korea
4Division of Rheumatology, Department of Internal Medicine, Ajou University Hospital, Gyeonggi-do, Suwon-si 443-721, Republic of Korea
5Division of Rheumatology, Department of Internal Medicine, Dong-A University Hospital, Busan 602-715, Republic of Korea
6Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-749, Republic of Korea
7Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University Hospital, Catholic University of Daegu School of Medicine, Daegu 705-718, Republic of Korea
8Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju 501-757, Republic of Korea
9Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 133-792, Republic of Korea

Received 28 July 2012; Accepted 4 November 2012

Academic Editor: Chi Chiu Mok

Copyright © 2012 So-Young Bang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Although two recent randomized placebo-controlled trials of rituximab (RTX) failed to demonstrate efficacy in systemic lupus erythematosus (SLE), clinicians continue to use off-label RTX for cases refractory to current treatments. We evaluated the effectiveness and safety of rituximab for patients with refractory SLE in Korea. Methods. We retrospectively analyzed multicenter patients treated with RTX in Korea. Results. 39 SLE patients treated with RTX were included in the following manner: lupus nephritis 43.6%, hematologic 33.3%, arthritis 7.8%, myositis 7.8%, and others 7.7%. All patients had responded poorly to at least one conventional immunosuppressive agent (mean , cyclophosphamide 43.6%, mycophenolate mofetil 48.7%, and other drugs) before RTX. Clinical improvements (complete or partial remission) occurred in patients with renal disease, hematologic disease, arthritis, myositis, and other manifestations at 6 months after RTX. The SLEDAI score was significantly decreased from at baseline to at 6 months, at 12 months, and at 24 months after RTX ( ). Among 28 clinical responders, 4 patients experienced a relapse of disease at months. Infections were noted in 3 patients (7.7%). Conclusion. RTX could be an effective and relatively safe therapeutic option in patients with severe refractory SLE until novel B-cell depletion therapy is available.