British Isles Lupus Assessment Group Biologics Register (BILAG-BR) data show that treatment with rituximab is associated with an improvement in disease activity in patients with refractory systemic lupus erythematosus (SLE). Among 270 patients commencing biologic therapy for refractory SLE between September 2010 and September 2015, 261 received rituximab. Response was achieved in 49% of the patients, and glucocorticoid use was also reduced at 6 months (P < 0.001). Serious infections were more frequent in the first 3 months after rituximab therapy, and occurred in 26 (10%) of the patients.