Rituximab Administration during the 2nd Trimester of Pregnancy for Systemic Lupus Erythematosus: Case Report and Review of the Literature in Rheumatic Disease

Rituximab is an anti-CD20 monoclonal antibody that is used in the treatment of many rheumatic diseases, for both licensed and unlicensed indications. Due to concerns regarding foetal B cell depletion and possible infection, there is conflicting advice about whether the drug should be administered during pregnancy, with some organizations advising administration if the potential benefit to the mother outweighs the risk to the foetus and some advising stopping rituximab six months prior to conception. Caution in particular is advised about administering rituximab in later trimesters when maternal IgG is transported across the placenta. There has been little literature thus far examining the safety of administering rituximab from the second trimester onwards in rheumatic diseases. We present a case where rituximab was used during the second trimester for the treatment of refractory systemic lupus erythematosus, without adverse effect on the neonate.

Faculty Scholarship and Productivity Expectations—An Administrator's Perspective

An organization can be effective only when its value system is congruent with and complementary to its central mission(s). The value system of a university is most clearly described by its promotion and tenure policies, processes, and the criteria it uses in evaluating a faculty member's performance. Professorial-rank faculty members at universities are required to perform assigned duties in teaching, research, extension, advising, administration, etc., that are unique to their position. All faculty members are required to make scholarly contributions and are encouraged to perform service that is relevant to their assignment and of value to their institution and profession. The balance of emphasis between assigned duties and scholarship varies from one faculty position to another—ranging from faculty with few assigned duties who engage predominantly in scholarship, to faculty with extensive assigned duties who devote a small, but significant, effort to scholarly achievement. A university's effectiveness can be compromised, and its faculty inappropriately evaluated, if this reality is not recognized; if scholarship is too narrowly interpreted; or if undue weight is given to individual achievement rather than to the achievements of individuals—including those that resulted from team efforts. Changes that are evolving at Oregon State Univ. to address these three issues will be described, including: adoption of a broader definition of scholarship as intellectual work that is validated by peers and communicated; a description of four fundamental forms of scholarship: discovery, development, integration, and creation; incorporation of a dynamic description of position responsibilities for each faculty member into annual and promotion and tenure evaluations; and addition of a category entitled, Results of team efforts into the format for faculty documentation of achievements.