Off-label use of rituximab in systemic lupus erythematosus: a systematic review

Abstract

Considerable interest in the efficacy of rituximab (a monoclonal CD20 antibody) in patients with systemic lupus erythematosus (SLE) has been generated due to its unique mode of action, culminating in a series of randomized and open trials, and case reports. However, this use is off-license and two significant RCTs have reported negative findings, reopening the debate on clinical benefit. This review of the available data suggests that rituximab induces B-cell depletion in 95% of patients, and a significant reduction in disease activity is achieved with a relatively good safety profile in patients with SLE.

Fig. 1

Process of selection of clinical trials in patients with SLE

Fig. 2

Percent change in disease activity scores following rituximab, by study sample size