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Khansa Osama Abdelkarim Aloub,1 Noha Ibrahim Ahmed Eltahirm,1,2 Elnour Mohammed Elagib,1,2 Mohammed Elmujtba Adam Essa,3,4 Mustafa Mohammed Ali Hussein3,4 1Department of Internal Medicine and Rheumatology, Omdurman Military Hospital, Omdurman, Sudan; 2Department of Medicine, Faculty of Medicine, Karary University, Omdurman, Sudan; 3Department of Clinical Medicine, Medical and Cancer Research Institute, Nyala, Sudan; 4Faculty of Medicine, Al fashir University, Al Fashir, SudanCorrespondence: Mohammed Elmujtba Adam Essa, Department of Clinical Medicine, Medical and Cancer Research Institute, Nyala, Sudan, Tel +24990700938, Email Awadali818@yahoo.comBackground: Renal affection in systemic lupus erythematosus (SLE) is a high-risk manifestation in which novel treatment strategies are required, particularly in patients who show lower response to conventional therapy. Rituximab has been used as an off-label treatment for lupus nephritis (LN) for the last ten years. This study aims to assess the outcome of the use of rituximab to treat LN patients.Methods: A retrospective cross-sectional study included 40 LN patients on Rituximab therapy who attended the Rheumatology clinic at Omdurman Military Hospital, Khartoum, Sudan. Between January to July 2020. Data were collected from the hospital records and included demographic, duration of disease and Rituximab doses. Renal biopsy, renal function parameters, albumin-creatinine ratio, hematological parameters and inflammatory markers. Assessment of the outcomes was conducted by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI score). Data were analyzed by using Statistical Package for Social Studies Program (SPSS, V. 21.0. IBM; Chicago). Chi-square test was used as significance test, the P. value was considered as significant at level 0.05 and akk continues variables had a normal distribution with KolmogorovâSmirnov test.Results: Renal function test showed significant improvement after 6 months of treatment with Rituximab. In addition, the mean of the SLE Activity Index 2000 (SLEDAI 2K) was significantly decreased with remarkable improvement in the histological degree of LN. The histology of renal biopsy of the patients commonly was diffuse proliferative nephritis followed by minimal mesangial glomerulonephritis, mesangial proliferative LN then membranous nephritis respectively. Improvement was common among the patients aged 20â 39 years, those with disease duration less than 5 years, who received 4 doses and rituximab as the initial modality.Conclusion: Rituximab therapy is effectively managing patients with lupus nephritis, after 6 months of follow-up, Patients showed remarkable clinical and laboratory improvement.Keywords: rituximab, LN, SLE, conventional therapy |
