The Effectiveness of Rituximab in the Treatment of Refractory Manifestations of Patients with Systematic Lupus Erythematous: A Retrospective Study

Background: Rituximab (RTX) is a chimeric antibody that directly targets B cells, which has been suggested as a new treatment option for systemic lupus erythematosus (SLE) resistant to conventional treatments. Objectives: This retrospective study aimed to investigate RTX's effect on treating SLE patients with refractory manifestations. Methods: This study was conducted on SLE patients who were resistant to treatment. The patients demographic characteristics and clinical information were collected from their medical records, and the results were compared before and after RTX therapy. Data were analyzed using SPSS software, and the significance level was less than 0.05 (P < 0.05). Results: Nephritis (26.3%), cutaneous manifestations (23.7%), and arthritis, occasionally secondary to overlap with rheumatoid arthritis (18.4%), were the most common complications that made patients (n = 55) candidates for the RTX biosimilar (Zytax). Ten patients were excluded due to a lack of complete data, and seven patients died immediately after starting Zytax due to disease severity and complications. Improvement in arthritis and cutaneous complications was reported after RTX injection in 57.1% and 44.4% of patients, respectively. Creatinine levels decreased significantly in patients with lupus nephritis after RTX injection compared to before treatment (P = 0.006). Moreover, anti-DNA was significantly different before and after RTX injection (Z = -2.89, P = 0.004). Comparison of C3 (t = 0.63; P = 0.53) and C4 (t = 1.72, P = 0.101) levels before and after RTX injection showed no significant differences. Conclusions: Based on the results, RTX improved nephritis, arthritis, and cutaneous complications in lupus patients.