Experiencia con rituximab en el tratamiento de pacientes con lupus eritematoso sistémico

García-Hernández, F.J.; Díaz-Cobos, C.; Callejas-Rubio, J.L.; Ocaña-Medina, C.; Ortego-Centeno, N.; Sánchez-Román, J.; de Ramón-Garrido, E.; Camps-García, M.T.

doi:10.1016/S1699-258X(06)73016-9

Información del artículo

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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