What is the role of rituximab in the treatment of lupus nephritis?

Updated: Mar 04, 2019
  • Author: Lawrence H Brent, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Rituximab, a B-lymphocyte–depleting therapy, appears to be effective in SLE and is being investigated as a treatment for SLE and lupus nephritis. Several small case series of rituximab have shown benefit in SLE and lupus nephritis. [60, 61, 62, 63]

More recently, however, a randomized, double-blind, phase II/III trial of rituximab in moderately-to-severely active SLE (EXPLORER) failed to show differences compared with placebo, although a beneficial effect of rituximab was noted in the African-American and Hispanic subgroups. [64]   A randomized, double-blind, phase III trial of rituximab in active proliferative lupus nephritis (LUNAR) showed that rituximab therapy resulted in more responders and greater reductions in anti-DNA antibodies in increases in C3 and C4 levels, but it did not improve clinical outcomes after 1 year of treatment. [65]

Other therapies under investigation for SLE and lupus nephritis are discussed below. [44, 66, 74, 68, 70]


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