Abstract
OBJECTIVES: B-cell depletion therapy has been used for over two decades to treat SLE, but there is a lack of studies reporting its impact on damage progression. This study aims to assess the effectiveness of rituximab in slowing damage acquisition. METHODS: We selected 380 patients 190 treated with rituximab and 190 controls, based on matched sex and age of onset, with standard immunosuppressive therapies-to compare the damage they developed, assessed by the SLICC/ACR Damage Index (DI). A secondary analysis of 111 patients was conducted to evaluate DI progression. RESULTS: The majority of patients were female (94.1%) and Caucasian (45.4%). Severe disease manifestations and higher titres of anti-dsDNA antibodies (86 U/ml vs 62 U/ml; P = 0.012) were seen in the rituximab group, in which SLICC/ACR DI was also higher (1.3 vs 0.9; P = 0.02). In the secondary analysis the SLICC/ACR DI mean had no statistical difference between the two groups (0.4 vs 0.6; P = 0.33), but we identified a statistical significance between the two groups regarding their DI progression (58.2% in the control group vs 44.2% in the rituximab). CONCLUSION: As an effective B-cell depleting therapy, rituximab is a valid therapeutic option for SLE patients, especially in those with refractory or life-threatening manifestations. While patients treated with rituximab initially had higher damage, their rate of damage progression was slower compared with those receiving standard therapies.