Lupus is a chronic condition that occurs when the body's immune system mistakenly attacks its own tissues. There are several types. Systemic lupus erythematosus (SLE) is the most common, accounting for about 70 percent of all cases of lupus.

SLE can affect many different tissues and organs of the body, like the joints, skin, kidneys, lungs, brain, central nervous system, blood vessels and heart. Patients may develop a characteristic, butterfly-shaped rash across the nose and cheeks. Exposure to sunlight can worsen the appearance of the rash. Other common signs include joint pain, extreme fatigue, anemia, loss of hair, mouth ulcers, swollen glands, changes in appetite/weight loss, mood disorders, problems with memory and concentration, dizziness and headaches, inflammation of the lining of the lungs or heart and seizures.

According to the Lupus Foundation of America, about 1.5 million Americans have some form of lupus. Women are affected 10 times more often than men. The condition can occur at any age, but is most commonly diagnosed between 15 and 45.

Treating SLE

There are several kinds of treatments for SLE. Patients are usually advised to limit exposure to sunlight, maintain a stretching and exercise program, eat a balanced diet and avoid alcohol. Nonsteroidal anti-inflammatory drugs may help reduce inflammation and pain. More severe symptoms can be treated with corticosteroids. In patients with major organ involvement, several other drugs or combinations of medications may also be used, like antimalarials, cyclophosphamide, methotrexate and azathioprine.

Research suggests traditional therapies for SLE are effective in reducing symptoms or producing remission in 70 to 90 percent of patients. However, the symptoms can still return, despite ongoing therapy. And sometimes the drugs produce significant toxic side effects (like an increased risk for infections).

Rituximab for SLE

Some doctors are testing the use of a potent cancer drug, called rituximab (Rituxan®). Rituximab is currently approved for treating Non-Hodgkin's Lymphoma. More recently it was approved for rheumatoid arthritis to be used in conjunction with methotrexate.

Rituximab targets a type of immune cell, called the B cell. Normally, these cells regulate the production of antibodies to help the body fight disease. In patients with SLE, the B cells produce antibodies that attack the body's own tissues.

Rituximab is given through an intravenous infusion. Once in the body, the drug seeks out and destroys the B cells. Hopefully, when the body makes new B cells, they won't attack the tissues and the disease will go into remission.

A few years ago, doctors at the University of Rochester began a small clinical trial to study the effectiveness of rituximab for SLE. After a one-time treatment, the researchers found most patients experienced a reduction in symptoms within a few months. Symptoms continued to improve over the next several months. A few patients experienced remission. Several studies are now underway across the country to try to replicate the results in a larger group of patients.

Health experts warn Rituximab is not approved for treatment of SLE and carries a risk of some significant adverse effects. The manufacturer reports severe infusion reactions and death can occur within two hours of the treatment. In December 2006, the FDA issued a safety warning for Rituximab when two SLE patients developed progressive multifocal leukoencephalopathy, a deadly viral infection of the central nervous system.

For general information on lupus:

American College of Rheumatology

The Arthritis Foundation

Lupus Foundation of America

National Institute of Arthritis and Musculoskeletal and Skin Diseases