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Effect of rituximab on long-term damage acquisition in patients with systemic lupus erythematosus

da Silva Brito, Amanda; Miranda, Sofia; Moitinho de Almeida, Teresa; Isenberg, David A; (2025) Effect of rituximab on long-term damage acquisition in patients with systemic lupus erythematosus. Rheumatology , 64 (9) pp. 5031-5036. 10.1093/rheumatology/keaf248. Green open access

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Abstract

Objectives: B-cell depletion therapy has been used for over two decades to treat SLE, but there is a lack of studies reporting its impact on damage progression. This study aims to assess the effectiveness of rituximab in slowing damage acquisition. Methods We selected 380 patients 190 treated with rituximab and 190 controls, based on matched sex and age of onset, with standard immunosuppressive therapies - to compare the damage they developed, assessed by the SLICC/ACR Damage Index (DI). A secondary analysis of 111 patients was conducted to evaluate DI progression. Results The majority of patients were female (94.1%) and Caucasian (45.4%). Severe disease manifestations and higher titres of anti-dsDNA antibodies (86 U/ml vs 62 U/ml; P = 0.012) were seen in the rituximab group, in which SLICC/ACR DI was also higher (1.3 vs 0.9; P = 0.02). In the secondary analysis the SLICC/ACR DI mean had no statistical difference between the two groups (0.4 vs 0.6; P = 0.33), but we identified a statistical significance between the two groups regarding their DI progression (58.2% in the control group vs 44.2% in the rituximab). Conclusion As an effective B-cell depleting therapy, rituximab is a valid therapeutic option for SLE patients, especially in those with refractory or life-threatening manifestations. While patients treated with rituximab initially had higher damage, their rate of damage progression was slower compared with those receiving standard therapies.

Type: Article
Title: Effect of rituximab on long-term damage acquisition in patients with systemic lupus erythematosus
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/rheumatology/keaf248
Publisher version: https://doi.org/10.1093/rheumatology/keaf248
Language: English
Additional information: This work is licensed under a Creative Commons License. The images or other third-party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Rheumatology, B-cell depleting agents, rituximab, systemic lupus erythematosus (SLE), lupus nephritis, damage index, cyclophosphamide, immunosuppressive agents, disease progression, EFFICACY, SAFETY, NEPHRITIS, THERAPY, DEPLETION, MORTALITY, COHORT
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10215559
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