#4-69E. Overcoming Refractory NPSLE: The Long-Term Impact of Rituximab (Clin Rheumatol, 2026)

Are you struggling to manage treatment-resistant neuropsychiatric systemic lupus erythematosus (NPSLE) in your daily practice? Today's episode examines a real-world study evaluating the long-term efficacy and safety of rituximab in 17 patients with refractory NPSLE. The research demonstrates that over 94% of participants achieved significant clinical improvement, accompanied by marked reductions in peripheral B-cells, overall disease activity scores, and daily glucocorticoid requirements. The most compelling finding is that rituximab facilitated sustained, relapse-free remission for a median follow-up of 45 months, suggesting a durable immune modulation that extends beyond transient B-cell depletion. However, when critically appraising this evidence, clinicians must carefully consider the study's methodological limitations, notably its small, single-center retrospective design, the absence of a randomized control group, and the potential confounding effects of concomitant rescue therapies. For practicing physicians, this paper is highly relevant as it highlights rituximab as a viable, steroid-sparing therapeutic alternative for severe cases unresponsive to conventional immunosuppressants, offering a critical strategy to prevent irreversible neurological damage.

Citation: Yue Zhao, Jianfen Meng, et al. Long-term clinical outcomes and safety of rituximab in refractory neuropsychiatric systemic lupus erythematosus: a real-world single-center study. Clinical Rheumatology. 2026. DOI: 10.1007/s10067-026-08164-1

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.