Rheumatology (Oxford). 2025 May 15:keaf248. doi: 10.1093/rheumatology/keaf248. Online ahead of print.
ABSTRACT
OBJECTIVES: B cell depletion therapy has been used for over two decades to treat systemic lupus erythematosus (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 Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR 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 titers 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.
PMID:40372703 | DOI:10.1093/rheumatology/keaf248
