Rituximab in systemic lupus erythematosus: An evidence based case report

Introduction: Systemic Lupus Erythematosus (SLE) is an autoimmune disease which may cause mortality and morbidity. Therefore, a good management should be done to improve patient outcome. There have been a lot of drug used to control the disease, however their usage are still controversy. Rituximab, which target B cells, shows a promising outcome but further evaluation is needed. The aim of this evidence based case report (EBCR) is to know the efficacy of rituximab as an additional treatment in SLE patients. Methods: Literature searching was conducted in PubMed, Science Direct, Google Scholar and Cochrane Library to find the available evidence. After finding the evidence needed, we evaluate the evidence by using critical appraisal questionnaire from Oxford Center of Evidence-Based Medicine and compare the validity and relevance criteria of each articles. Results: From four databases, four articles were selected for further appraisal. Those articles included one systematic review, one randomized clinical trial and two prospective study. Rituximab in addition to standard therapy showed a clinically higher response compare to standard therapy with response varied from 57–100% compare to standard therapy (varied from 45.9–92.8%). However, when measured statistically, there were no statistically significant (p > 0.05) difference between addition of rituximab group and standard treatment. Conclusion: Rituximab as an additional treatment may be clinically effective in improving SLE patients’ outcome and safe to be used in SLE management.