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Vol. 2. Núm. 1.
Páginas 23-30 (Enero - Febrero 2006)
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Vol. 2. Núm. 1.
Páginas 23-30 (Enero - Febrero 2006)
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Experiencia con rituximab en el tratamiento de pacientes con lupus eritematoso sistémico
Experience with rituximab in the treatment of systemic erythematosus lupus
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...
F.J. García-Hernándeza, C. Díaz-Cobosb, J.L. Callejas-Rubioc, C. Ocaña-Medinaa, N. Ortego-Centenoc,��
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nortego@telefonica.net

Correspondencia: Dr. N. Ortego-Centeno. Unidad de Enfermedades Autoinmunes Sistémicas. Hospital Clínico San Cecilio. Avda. Dr. Oloriz, s/n. 18012. Granada. España.
, J. Sánchez-Romána, E. de Ramón-Garridob, M.T. Camps-Garcíab
a Unidad de Colagenosis e Hipertensión Pulmonar. Hospital Virgen del Rocío. Sevilla. España
b Unidad de Enfermedades Autoinmunes Sistémicas. Hospital Carlos Haya. Málaga. España
c Unidad de Enfermedades Autoinmunes Sistémicas. Hospital Clínico San Cecilio. Granada. España
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Objetivo

Analizar la efectividad y tolerancia a corto plazo de la terapia con rituximab (RTX) en pacientes con lupus eritematoso sistémico (LES) y diferentes manifestaciones clínicas.

Pacientes y métodos

Se estudió a un total de 13 pacientes. El RTX fue indicado en 6 ocasiones para el tratamiento de nefritis refractaria, en 5 para el tratamiento de trombocitopenia grave, en 1 para el tratamiento de aplasia medular y en 1 para el tratamiento de vasculitis peritoneal asociada a nefritis. Los 13 pacientes fueron tratados con 4 dosis semanales de 375 mg/m2 de RTX. El tiempo medio de seguimiento fue 12±8,5 meses. Nueve pacientes experimentaron una respuesta favorable; 3 con nefropatía, 5 con trombocitopenia y 1 con vasculitis peritoneal y nefritis. El SLEDAI medio pasó de 11 a 6,5. Dos pacientes con trombocitopenia presentaron recidivas; y la respuesta al retratamiento fue buena.

Conclusiones

El presente estudio demuestra que RTX es un fármaco efectivo y seguro, a corto plazo, en el tratamiento de diferentes manifestaciones clínicas asociadas al LES.

Palabras clave:
Rituximab
Anti CD20
Lupus eritematoso sistémico
Nefritis
Trombocitopenia
Objective

To assess the short-term effectiveness and tolerance of rituximab in patients with systemic lupus erythematous and distinct clinical manifestations.

Patients and methods

Thirteen patients were studied. Rituximab (RTX) was indicated for refractory nephritis in 6 patients, severe thrombocytopenia in 5, aplastic anemia in 1 and peritoneal vasculitis associated with nephritis in 1. All patients received 4 weekly doses of 375 mg/m2 of RTX. The mean length of follow-up was 12±8.5 months. Response was favorable in 9 patients: 3 with nephritis, 5 with thrombocytopenia and 1 with peritoneal vasculitis and nephritis. The mean SLE disease activity index decreased from 11 to 6.5 points. Thrombocytopenia recurred in 2 patients, who responded well to retreatment.

Conclusions

The present study demonstrates that RTX is safe and effective as short-term therapy for distinct clinical manifestations associated with SLE.

Key words:
Rituximab
Anti CD20
Systemic lupus erythematosus
Nephritis
Thrombocytopenia
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Copyright © 2006. Elsevier España S.L. Barcelona
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