The purpose of this study is to determine the safety and effectiveness of rituximab (anti-CD20) in treating systemic lupus erythematosus (SLE). White blood cells in the body called B cells give off substances that are active in promoting SLE disease. Researchers have found that anti-CD20 can block production of these substances in another disease. This study explores whether anti-CD20 will also be safe in people with SLE and whether it may be effective in treating SLE.
B cells clearly play an essential role in the pathogenesis of SLE since they produce autoantibodies. Clinical observations support the contention that intervening in the production of autoantibodies by the B lymphocyte will be effective therapy. Current approved therapy for B-cell non-Hodgkin's lymphoma includes anti-CD20. The results of anti-CD20 administration in SLE are anticipated to be similar to those in lymphoma patients. The current proposal explores the mechanisms and applicability of B-cell depletion as a potential treatment for SLE. Participants receive 4 weekly infusions of study medication. Each participant is enrolled in the study for a total of 1 year with protocol visits weekly for the first 3 months, then every other week for the next 2 months, every month for the next 4 months, and every other month for the remaining 5 months of the study (Weeks 0, 1, 2, 3, 4, 5, 6, 7, 9, 11, 13, 15, 19, 23, 27, 31, 39, 47, and 55). Responses to exogenous antigens are measured; assessments for clinical response with SLE-disease activity score (SLEDEI) and systemic lupus activity measure (SLAM) score are performed. Participants complete a health questionnaire and a health survey and laboratory parameters are evaluated.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Subjects received four weekly infusions of rituximab at a dose of 375 mg/m\^2
University of Colorado
Denver, Colorado, United States
University of Rochester
Rochester, New York, United States
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Serum Autoantibodies
Time frame: Baseline, Week 4, Week 12, Week 24, Week 36 and Week 56
Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)
Time frame: Baseline, Week 4, Week 7, Week 11, Week 15, Week 19, Week 27, Week 39 and Week 55
C3 and C4 complement levels
Systemic Lupus Activity Measure (SLAM)
Time frame: Baseline, Week 4, Week 7, Week 11, Week 15, Week 19, Week 27, Week 39 and Week 55
Erythrocyte Sedimentation Rate (ESR)
Prednisone Dose
Time frame: Baseline, Week 4, Week 12, Week 24, Week 36 and Week 56
Renal Function
Measured by creatinine clearance and total protein.
Modified Health Assessment Questionnaire (HAQ)
Short Form-36 Health Survey (SF-36)
Physician Global Assessment (VAS)
Patient Global Assessment (VAS)
Systemic Lupus Erythematosus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index for SLE
Adverse Events
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