1. Rituximab has been useful in cases of sev ere lupus as well as lupus nephritis. Recent data suggests that it work particularly well with cyclophospamide. Previous studies on rituximab (both published in peer-reviewed journals and presented at various national and international meetings) have been extremely encouraging for the use of rituximab in SLE or Sjögren’s syndrome.The combination of cyclophosphamide and rituximab is an exciting new therapy for people with lupus, and many doctors are now using it for adults as well as children with severe disease. what happens. However, complications such as PML and even death have been reported.A recent US Food and Drug Administration Alert, issued in December 2006, highlighted important safety information about rituximab in patients with SLE. It has been shown that rituximab can cause exacerbations of viral infections or viral reactivation, including reactivation of the JC virus which can lead to progressive multifocal leukoencephalopathy (PML). The alert warns physicians to maintain a high level of suspicion for PML in patients treated with rituximab.
As far as remicade, it has been reported to cause a lupus like illness. It is now in a study NCT00368264 and is clearly investigational. Tacrolimus isa new promising drug but it is currently in studies.
2. Tahir H, Rohrer J, Bhatia A, Wegener WA, Isenberg DA. Humanized anti-CD20 monoclonal antibody in the treatment of severe resistant systemic lupus erythematosus in a patient with antibodies against rituximab. Rheumatology (Oxford). 2005;44:561-562. Abstract
3. van Vollenhoven RF, Gunnarsson I, Welin-Henriksson E, et al. Biopsy-verified response of severe lupus nephritis to treatment with rituximab (anti-CD20 monoclonal antibody) plus cyclophosphamide after biopsy-documented failure to respond to cyclophosphamide alone. Scand J Rheumatol. 2004;33:423-427. Abstract
4. Tanaka Y, Yamamoto K, Takeuchi T, et al. A multi-center phase I/II trial of rituximab for treatment of refractory systemic lupus erythematosus. Program and abstracts of the American College of Rheumatology 70th Annual Meeting; November 11-15, 2006; Washington, DC. Presentation 537.
5. Jonsdottir T, Gunnarsson I, Risselada A, et al. Serological changes in patients with severe SLE treated with rituximab and cyclophosphamide. Program and abstracts of the American College of Rheumatology 70th Annual Meeting; November 11-15, 2006; Washington, DC. Presentation 539.