AimTo investigate the clinical and radiological outcomes and glucocorticoid‐sparing effect of rituximab therapy in 13 patients with retroperitoneal fibrosis (RPF).MethodsWe analyzed the data of both glucocorticoid‐naive and glucocorticoid‐resistant RPF patients who were treated with rituximab. Demographic features, positron emission tomography computed tomography (PET‐CT) findings, and clinical and histopathologic outcomes were collected retrospectively.ResultsWe evaluated the data of 13 RPF patients (8M/5F). The median follow‐up duration was 28 months (interquartile range [IQR] 24.5–55.5 months) and median age at the time of diagnosis was 50.8 years (IQR 46.5–54.5 years). PET‐CT scans showed that following the rituximab therapy, the craniocaudal diameter of the RPF mass reduced from 74 mm (IQR 50.5–130 mm) to 52 mm (IQR 35–77 mm; p = .06), and periaortic thickness of the RPF mass reduced from 14 mm (5.5–21.9 mm) to 7 mm (4.5–11 mm; p = .12). The maximum standardized uptake value (based on body weight) of the RPF mass decreased from 5.8 (4.3–9.7) to 3.1 (2.8–5.3) after the therapy (p = .03). The number of patients with hydronephrosis reduced from 11 to 6 following rituximab therapy (p = .04). Before rituximab, nine patients received a median dose of 10 mg (IQR 0–27.5 mg) prednisolone per day. After the rituximab treatment, we discontinued prednisolone treatment for four out of nine patients and reduced the daily dose for the remaining patients. At the time of the final evaluation of the patients, the median prescribed prednisolone dose was 5 mg/day (IQR 2.5–7.5 mg/day; p = .01).ConclusionOur study shows that rituximab may be a favorable treatment option for glucocorticoid‐refractory RPF patients with high disease activity on PET‐CT scans.
Aim
This study aimed to show the effectiveness of interleukin (IL)‐23 inhibitors in psoriatic arthritis (PsA) at weeks 12 and 24 in a real‐world setting.
Materials and Methods
Forty‐three patients with active PsA were enrolled in this study. These patients were treated with either guselkumab (n = 20) or risankizumab (n = 23). Treatment responses at the 12th and 24th weeks were evaluated with the parameters of the number of joints with active arthritis, Psoriasis Area Severity Index (PASI) response rate, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, Disease Activity Index for Psoriatic Arthritis (DAPSA) score, and C‐reactive protein (CRP) value. The study's primary endpoint was BASDAI ≤ 4 and DAPSA ≤ 14 at week 24, and the secondary endpoint was the absence of joints with clinically active arthritis signs at week 24.
Results
IL‐23 inhibition significantly improved all treatment response parameters at the 12th and 24th weeks (P < 0.001). While 90% of patients reached the primary endpoint with anti‐IL23 therapy, 74% achieved the secondary endpoint. Both biologic‐naïve and biologic‐experienced patients responded significantly to anti‐IL‐23 therapy. Also, no adverse events related to anti‐IL‐23 agents were observed.
Conclusions
The response parameters indicating the severity of PsA (the number of joints with active arthritis, BASDAI score, DAPSA score, and CRP value) and a parameter indicating the severity of skin involvement, that is, PASI score, significantly improved with anti‐IL‐23 therapy at weeks 12 and 24. Moreover, significant improvement was achieved at week 24 compared to week 12 in all response parameters.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.