Arthritis Care & Research Vol. 69, No. 6, June 2017, pp 857–866 DOI 10.1002/acr.22993 C 2016 The Authors. Arthritis Care & Research published by Wiley V Periodicals, Inc. on behalf of American College of Rheumatology. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

ORIGINAL ARTICLE

Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long-Term Effects on Serum Immunoglobulins VENKAT REDDY,1 LINA MARTINEZ,2 DAVID A. ISENBERG,1 MARIA J. LEANDRO,1 GERALDINE CAMBRIDGE1

AND

Objective. B cell–depletion therapy based on rituximab is a therapeutic option for refractory disease in patients with systemic lupus erythematosus (SLE). The aim of this observational study was to document long-term effects on B cell function by following serum immunoglobulin levels in patients with SLE treated with rituximab in routine clinical practice. Methods. We included 57 consecutive patients with SLE treated with rituximab and concomitant/sequential immunosuppressants and measured serum total IgG, IgM, and IgA and IgG anti-dsDNA antibodies, over a median of 48 months most recent followup. Flow cytometry was used prospectively to assess B cell phenotypes in 17 of 57 patients. Results. Twelve patients (21%) had persistent IgM hypogammaglobulinemia (