Clinical outcomes of neuropsychiatric systemic lupus erythaematosus after anti-CD20 antibody treatment
| Patient | Dose of rituximab | Other treatments at study entry (mg) | CNS manifestations | Objective NPSLE findings after treatment | Duration of remission (m) | |
|---|---|---|---|---|---|---|
| before | after | |||||
| Bet, betamethasone; BPRS, brief psychiatric rating scale; CNS, central nervous system; GCS, Glasgow Coma Scale; m-PSL, methylprednisolone; MRI, magnetic resonance imaging; NPSLE, neuropsychiatric systemic lupus erythaematosus; PET, 18FTG-positron emission tomography; PSL, prednisolone; SDS, self-rating depression scale; SPECT, single photon emission computed tomography. For other abbreviations, see table 1. | ||||||
| 1 | 375 mg/m2 day 1, 8 | Bet 1.0 | Consciousness disorder, seizure, psychosis | Complete recovery (GCS 7–11→15/5 days) | Improvement of SPECT | 22 |
| 2 | 375 mg/m2 day 1, 15 | Bet 1.5 | Consciousness disorder | Improved consciousness | No follow-up data | 18 |
| 3 | 375 mg/m2 day 1, 8 | Bet 1.0 | Consciousness disorder, seizure | Complete recovery (GCS 3→14/2 days) | No improvement in MRI and SPECT | 23 |
| 4 | 375 mg/m2 day 1, 8 | m-PSL 20 | Headache | Resolution of headache | Improved IgG index (1.05 →0.84/4 w) | 29 |
| 5 | 375 mg/m2 day 1, 8 | Bet 1.25 | Paresthesia of fingers, toes and left precordial-back | Resolution of paresthesia | Improvement of neck MRI | 7 |
| 6 | 500 mg day 1, 8, 15, 22 | Bet 2.5 | Depressive state, insomnia | Improvement of depressive state | Improvement of SPECT | 7 |
| 7 | 500 mg day 1, 8, 15, 22 | Bet 1.25 | Paresis of both lower limbs, muscle weakness, depressive state | Reduction of paresis, improvement of depressive state (SDS 58→50/2 w) | Improvement of SPECT, improvement of IgG index (0.80 →0.72/3 m) | 14 |
| 8 | 1000 mg day 1, 15 | Bet 1.25, AZ 50 | Psychosis, cognitive dysfunction | Improvement of psychosis (BPRS 26→7/8 w) | Improvement of SPECT | 11 |
| 9 | 375 mg/m2 day 1 | PSL 45 | Consciousness disorder, psychosis, paresis of both lower limbs, neurological bladder | Complete recovery | Improvement of PET and MRI, improved IgG index (0.98 →0.61/2 w) | 10 |
| 10 | 375 mg/m2 day 1, 8 | Bet 3 | Consciousness disorder, hallucination, cataplexy | Complete recovery | No significant improvement in objective findings | 4 |