title: Rituximab treatment for 'rhupus syndrome': clinical and power-Doppler ultrasonographic monitoring of response. A longitudinal pilot study.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of rituximab in patients suffering from rhupus unresponsive to therapy with non-biological disease-modifying anti-rheumatic drugs (DMARDs).
  
  
  METHODS
  Six patients fulfilling criteria for both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) and with a DAS28 score >5.1 were enrolled to receive two fortnightly 1000 mg rituximab doses at baseline and after 28 weeks. All patients underwent clinical, laboratory, and power- Doppler (PD) ultrasonographic (US) assessment at baseline and after 14, 28 and 56 weeks.
  
  
  RESULTS
  A sustained improvement in DAS28, SLEDAI, HAQ, laboratory markers and ultrasound indices together with a significant reduction in the daily dose of prednisone were observed throughout follow-up.
  
  
  CONCLUSIONS
  Rituximab may be a safe and effective therapeutic option in refractory rhupus patients.
authors.affiliation: Chair of Rheumatology and Rheumatology Unit, University Clinic and AOU of Cagliari, Cagliari, Italy. matteopiga@alice.it
authors.forename: M
authors.initials: M
authors.lastname: Piga
authors.forename: A
authors.initials: A
authors.lastname: Gabba
authors.forename: A
authors.initials: A
authors.lastname: Cauli
authors.forename: P
authors.initials: P
authors.lastname: Garau
authors.forename: A
authors.initials: A
authors.lastname: Vacca
authors.forename: A
authors.initials: A
authors.lastname: Mathieu
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010865:Pilot Projects; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D000069283:Rituximab; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D007155:Immunologic Factors; D000069283:Rituximab; D011241:Prednisone
keywords: musculoskeletal ultrasound; rheumatoid arthritis; rhupus; rituximab; systemic lupus erythematosus