{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:10:08Z","timestamp":1783008608495,"version":"3.54.5"},"reference-count":25,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2016,11,23]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Previous reports indicate that treating patients with lupus (SLE) at or close to the time of diagnosis successfully without using any, or minimal, corticosteroids by using B-cell depletion (BCD) is possible in the short-term. It is not however known whether using BCD is as effective or reduces corticosteroid use in the long-term. We report the long-term (up to 7\u2005years) use of BCD with respect to its steroid-saving capacity and clinical effectiveness in newly diagnosed SLE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Sixteen female patients with SLE were treated at, or shortly after diagnosis, with BCD therapy (BCDT) minimising the routine use of oral steroids. Post-treatment, most patients were given hydroxychloroquine (n=14) and azathioprine (n=10). The British Isles Lupus Assessment Group (BILAG) disease activity index was used for clinical assessment. Serum antidouble-stranded DNA (dsDNA) antibodies, complement (C3), erythrocyte sedimentation rate (ESR), circulating B lymphocytes (CD19<jats:sup>+<\/jats:sup>) and total inmmunoglobulins were tested every 2\u20136\u2005months (average of 4.5\u2005years) (SD 2) post-treatment. Disease activity and steroid requirement were compared with three patients with SLE treated conventionally, each matched for ethnicity, sex, age, clinical features, disease duration at diagnosis and follow-up period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All patients given rituximab achieved BCD. The mean number of flares during follow-up (new BILAG A or B) was 2.63 (SD 3) in the BCDT group and 4 (SD 3.6) in the controls (NS, p=0.14). Post-BCDT, mean anti-dsDNA antibody level fell from 1114\u2005U\/mL (SD 1699.3) to 194 (SD 346.7) at 18\u2005months (p=0.043), mean serum ESR fell by &gt;70% at 6\u2005months maintained during follow-up and serum C3 level normalised in 8 patients. The mean cumulative prednisolone dose at 60\u2005months for the patients who underwent BCDT (n=11) was 4745.67\u2005mg (SD 6090\u2005mg) vs 12\u2005553.92\u2005mg (SD 12\u2005672\u2005mg) for the controls (p=0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Early treatment of patients with SLE with BCDT is safe, effective and enables a reduction in steroid use.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/lupus-2016-000182","type":"journal-article","created":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T20:41:32Z","timestamp":1486068092000},"page":"e000182","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["The use of rituximab in newly diagnosed patients with systemic lupus erythematosus: long-term steroid saving capacity and clinical effectiveness"],"prefix":"10.1136","volume":"4","author":[{"given":"Borja","family":"Gracia-Tello","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Lozano Blesa University Hospital, Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amara","family":"Ezeonyeji","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology, University College London Hospitals, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Isenberg","sequence":"additional","affiliation":[{"name":"Centre for Rheumatology, University College London Hospitals, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,2,2]]},"reference":[{"key":"2025091515013782000_4.1.e000182.1","first-page":"856","article-title":"Disease activity patterns in a monocentric cohort of SLE patients: a seven-year follow-up 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