Intensive short-term treatment with rituximab, XXXX and @entity1667 pulses induces remission in severe cases of @entity1252 with nephritis and avoids further immunosuppressive maintenance therapy.

@entity1 @entity1667 @entity644 @entity137 @entity625 @entity827 @entity66 @entity39 @entity229 @entity2225 @entity1252 @entity786 @entity1701 @entity425 @entity305 @entity272 @entity4841 @entity221
BACKGROUND: B cells play a central role in @entity1252 ( @entity1252 ). Rituximab is expected to induce apoptosis of all the @entity2225 -positive B cells. A proportion of @entity1 are refractory or intolerant to standard immunosuppression. These are candidate to new therapeutic options. METHODS: Eight @entity1 [six @entity1 , two @entity1 , mean age 41-year-old (27-51), with severe multiorgan involvement (kidney, skin, nervous system, @entity625 , @entity827 , @entity1701 )] were considered eligible for an intensive combination therapy including rituximab. Rituximab was administered (dose 375 mg/m(2)) on Days #2, 8, 15 and 22. Two more doses were administered 1 and 2 months following the last weekly infusion. This treatment was combined with two pulses of 750 mg @entity786 (Days #4 and 17) and three pulses of 15 mg/kg (Days #1, 4 and 8) @entity1667 followed by oral @entity229 , 50 mg for 2 weeks rapidly tapered until 5 mg in 2 months. Response was evaluated by assessing the changes in clinical signs and symptoms [Systemic Lupus @entity66 Activity Index (SLEDAI score)] and laboratory parameters for at least 12 months. RESULTS: Levels of erythrocyte sedimentation rate and anti-double-strand DNA antibodies significantly decreased (P < 0.01 at 12 months), whereas C3 and mainly C4 values increased at 6 months (P < 0.01 for C4). @entity644 improved in the cases with renal involvement (P < 0.01 at 3, 6 and 12 months). SLEDAI score improved moving from the mean 17.3 (12-27) before therapy to 3.1 (1-5) after rituximab treatment. Constitutional symptoms including @entity4841 , @entity425 and @entity221 disappeared in all the previously affected @entity1 ; paresthesia improved in the four @entity1 with @entity305 and @entity272 gradually resolved in the @entity1 with @entity39 skin ulcers at presentation. @entity137 were negligible. CONCLUSIONS: Long-lasting remissions were obtained in @entity1 with severe @entity1252 and major organ involvement by this intensive administration of rituximab combined with low doses of intravenous @entity786 and @entity1667 pulses followed by a rapid tapering of @entity229 to 5 mg/day as a sole maintenance therapy.
