Rituximab ( Rituxan ), a drug used to treat cancer, may also benefit people with lupus erythematosus who have complications of the central nervous system.

Lupus is a disorder of the immune system in which the body attacks itself, causing pain, inflammation and diffuse damage to many organs.
In a significant number of cases, the central nervous system is effected which can lead to psychiatric and neurological disturbances.
This form of lupus dramatically reduces the quality of life for patients, more so than other manifestations of the disease in which, for example, the kidneys might be affected.

Michael Neuwelt, at the University of Californian San Francisco ( UCSF ) and Stanford University, presented results of a trial involving 22 patients over 16 months. " I spent considerable time with oncologists and saw how the drug works in patients with non-Hodgkins lymphoma. Patients with blood disorders of lupus and severe complications of the central nervous system ( CNS ) also surprisingly improved," he said.

Over half of the patients received Rituximab, others received it in combination with steroids, and one-third with the current standard treatment of severe CNS lupus with chemotherapy, Cyclophosphamide, combined with Rituximab.

Rituximab targets CD20 positive B cells and uniquely removes those early B cells before they become harmful.

" Rituximab appears to be quite effective. It is a treatment lasting up to six months with a low risk of side-effects, compared to previous treatments of high-dose steroids, and chemo-therapy," said Neuwelt.

There was a significant improvement in 16 of the patients and four others were stabilized. Brain scans demonstrated that the adverse changes that occurred with the disease improved.

Neuwelt is concerned about the depletion of the B cells by Rituximab for the long term. However, the risk/benefit ratio from this new treatment in its early stages is extremely promising.

" It is the first drug in my 26 years of treating patients with severe central nervous system lupus, used alone or in combination with other therapies that has not only significantly boosted the quality of life for patients with this dreadful disease, but also reduced the burden of side effects of standard treatment with steroids and Cyclophosphamide. However, we desperately need randomized-controlled trials." he concluded.

Source: Annual European Congress of Rheumatology, EULAR 2005


XagenaMedicine2005