Rituximab treatment for 'rhupus syndrome': clinical and power-Doppler ultrasonographic monitoring of response. A longitudinal pilot study

Lupus. 2013 May;22(6):624-8. doi: 10.1177/0961203313482741. Epub 2013 Apr 4.

Abstract

Objective: To evaluate the safety and efficacy of rituximab in patients suffering from rhupus unresponsive to therapy with non-biological disease-modifying anti-rheumatic drugs (DMARDs).

Methods: Six patients fulfilling criteria for both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) and with a DAS28 score >5.1 were enrolled to receive two fortnightly 1000 mg rituximab doses at baseline and after 28 weeks. All patients underwent clinical, laboratory, and power- Doppler (PD) ultrasonographic (US) assessment at baseline and after 14, 28 and 56 weeks.

Results: A sustained improvement in DAS28, SLEDAI, HAQ, laboratory markers and ultrasound indices together with a significant reduction in the daily dose of prednisone were observed throughout follow-up.

Conclusion: Rituximab may be a safe and effective therapeutic option in refractory rhupus patients.

Keywords: musculoskeletal ultrasound; rheumatoid arthritis; rhupus; rituximab; systemic lupus erythematosus.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / adverse effects
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / therapeutic use
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / drug therapy*
  • Dose-Response Relationship, Drug
  • Follow-Up Studies
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Longitudinal Studies
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / diagnostic imaging
  • Lupus Erythematosus, Systemic / drug therapy*
  • Pilot Projects
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Prospective Studies
  • Rituximab
  • Severity of Illness Index
  • Treatment Outcome
  • Ultrasonography, Doppler

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antirheumatic Agents
  • Immunologic Factors
  • Rituximab
  • Prednisone