Rituximab Therapy in Refractory Neuropsychiatric Lupus: Current Clinical Evidence

Narváez, Javier; Ríos-Rodriguez, Valeria; Fuente, Diana de la; Estrada, Paula; López-Vives, Laura; Gómez-Vaquero, Carmen; Nolla, Joan M.

doi:10.1016/j.semarthrit.2011.06.004

Cited by 87 publications

(50 citation statements)

References 30 publications

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“…Refractory patients and those recently treated with a cyclophosphamide or a calcineurin inhibitor were excluded in this trial. However, most of these patients were included in our study and other open-label studies and case reports [26]. Furthermore, the LUNAR trial that included patients diagnosed as having lupus nephritis class III or IV did not find any differences in the overall response rate between rituximab and placebo [27].…”

Section: Discussionmentioning

confidence: 88%

Available evidence and outcome of off-label use of rituximab in clinical practice

Danés

Agustí

Vallano

et al. 2013

Eur J Clin Pharmacol

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Purpose: To analyze the therapeutic indications for off-label use of rituximab, the available evidence for its use, the outcomes, and the cost. Conclusions:Off-label rituximab is mainly used for the treatment of haematological, kidney and systemic connective tissue disorders, and the response was variable depending on the diseases. The level of evidence in these indications was low and the cost very high. More clinical trials are needed, although they can be difficult in some rare diseases. Data from observational studies may provide useful information to assist prescribing in clinical practice.

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Section: Discussionmentioning

confidence: 88%

Available evidence and outcome of off-label use of rituximab in clinical practice

Danés

Agustí

Vallano

et al. 2013

Eur J Clin Pharmacol

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“…14,23,24 Plasma exchange therapy, i.v. immunoglobulin and rituximab 25 have been used in refractory cases and anticoagulation therapy in antiphospholipid-positive with variable results. 10,11,22 In our experience the treatment produced only partial improvement.…”

Section: Resultsmentioning

confidence: 99%

Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases

Hryb

Chiganer

Contentti

et al. 2016

Spinal Cord Ser Cases

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“…; grade 3D) [22,24]. In refractory cases, the proposed therapeutic schemes include IVIg, plasmapheresis, and B-cell depletion therapy with rituximab, based on small case series (grade 3D) [12,25,26]. The recently released SLEspecific anti-Blys/ BAFF monoclonal antibody belimumab has not been tested in SLE patients with CNS involvement and its therapeutic value remains uncertain [27].…”

Section: Acute or Subacute Meningoencephalitis Presenting As Acute Comentioning

confidence: 99%

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

et al. 2016

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Neurological involvement is relatively common in the majority of systemic autoimmune diseases and may lead to severe morbidity and mortality, if not promptly treated. Treatment options vary greatly, depending on the underlying systemic pathophysiology and the associated neurological symptoms. Selecting the appropriate therapeutic scheme is further complicated by the lack of definite therapeutic guidelines, the necessity to differentiate primary neurological syndromes from those related to the underlying systemic disease, and to sort out adverse neurological manifestations caused by immunosuppressants or the biological agents used to treat the primary disease. Immunotherapy is a sine qua non for treating most, if not all, neurological conditions presenting in the context of systemic autoimmunity. Specific agents include classical immune modulators such as corticosteroids, cyclophosphamide, intravenous immunoglobulin, and plasma exchange, as well as numerous biological therapies, for example antitumor necrosis factor agents and monoclonal antibodies that target various immune pathways such as B cells, cytokines, and co-stimulatory molecules. However, experience regarding the use of these agents in neurological complications of systemic diseases is mainly empirical or based on small uncontrolled studies and case series. The aim of this review is to present the state-of-the-art therapies applied in various neurological manifestations encountered in the context of systemic autoimmune diseases; evaluate all treatment options on the basis of existing guidelines; and compliment these data with our personal experience derived from a large number of patients.

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Rituximab Therapy in Refractory Neuropsychiatric Lupus: Current Clinical Evidence

Cited by 87 publications

References 30 publications

Available evidence and outcome of off-label use of rituximab in clinical practice

Available evidence and outcome of off-label use of rituximab in clinical practice

Myelitis in systemic lupus erythematosus: clinical features, immunological profile and magnetic resonance imaging of five cases

Immunotherapies for Neurological Manifestations in the Context of Systemic Autoimmunity

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