Treatment

a b s t r a c t Rhupus in an infrequent disease in which an overlap between lupus eritematosus and rheumatoid arth-ritis exists. Joint manifestations are prominent and treatment with nonbiological DMARDs is not always satisfactory, so immunosuppressors and biological agents have been tried. A prospective, open clinical studywas done to evaluate efficacy and tolerability of rituximab in patients with rhupus. The main objective was a change in DAS28 at 6 months and secondary objectives were a change in MEX-SLEDAI at 6 months, change in DAS28 and MEX-SLEDAI during follow up, steroid requirements and detection of adverse events. We included 9 women with a mean age of 43 years and disease duration of 10 years. A significant reduction in DAS28 was observed (from 5.73 at baseline to 3.02 at 6 months, P<.001). Improvement in DAS28 was maintained during follow up. At 6 months, 3 patients were in remission and 3 had low disease activity. MEX-SLEDAI diminished from 5 points at baseline to 1.22 at 6 months (P<.001). There was a negative correlation between clinical improvement and anti-CCP levels (r=−0.794, P=.011). Mean prednisonedosewas reduced from11.66mg/day at baseline to0.55 and1.11mg/day at 12 and24months. Treatment was well tolerated. In this study rituximabwas effective not only for joint affection but also for othermanifestations of the disease.We consider that this biological agent can be a good therapeutic option for patients with rhupus. © 2012 Elsevier España, S.L. All rights reserved. Eficacia y tolerabilidad de rituximab en el tratamiento de pacientes con rhupus Palabras clave