Rituximab is an effective treatment for lupus nephritis that enables reductions in maintenance steroids, data show.

Ruth Pepper, MD, of Hammersmith Hospital in London, and colleagues, studied 18 patients with class III-IV lupus nephritis, all of whom were on steroids prior to development of lupus nephritis.

These patients received rituximab induction therapy and mycophenolate mofetil maintenance therapy. Of the 18 patients, 14 (78%) achieved complete or partial remission with a sustained response in 12 patients (67%) at one year, according to findings published in Nephrology Dialysis Transplantation (2009; published online ahead of print). Two subjects had a relapse of proteinuria. Four patients did not respond.

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The researchers observed a significant decrease in proteinuria from a mean protein to creatinine ratio of 325 mg/mmol at presentation to 132 mg/mmol at one year.

In addition, serum albumin levels increased significantly from a mean of 29 g/L at presentation to 34 g/L at one year. The cohort had a low complication rate with no severe infections. After treatment with rituximab, six patients stopped taking prednisolone, six decreased their maintenance dose, and six remained on the same dose.