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Rituximab (RTX) treatment of lupus (SLE) patients remains a therapeutic option, especially in refractory SLE. An observational UK cohort of 261 refractory SLE patients were followed in the BILAG-BR registry.
Patients starting biologic therapy between 2010 and 2015 were enrolled. Glucocorticoids were used in 93% of patients.
Response rates at 6 months were available for 68% of patients. After 6 mos. of RTX, median BILAG scores dropped from at baseline to 3 at 6 months (P < 0.0001).
During the same period the median SLEDAI-2K reduced from 8 to 4 (0-7) (P < 0.001).
Half (49%) of patients achieved a response along with a significant reduction of glucocorticoid dose to 7.5 mg at 6 months (P < 0.001).
Serious infections occurred in 10% patients.
Despite large randomized trials failing to show the efficacy of RTX in SLE (LUNAR https:/buff.ly/2BDE725 and EXPLORER https://buff.ly/2BCHy99), uncontrolled observational data suggests possible efficacy and safety of RTX in refractory SLE.