Efficacy of rituximab in resistant palindromic rheumatism: first report in literature

Raghavan, Padmaja; Sreenath, Sreelakshmi; Cherian, Somy; Shenoy, Padmanabha

doi:10.1007/s10067-019-04578-2

Cited by 12 publications

(11 citation statements)

References 9 publications

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“…Disease remission (defined as the absence of flares for ≥1 month) on therapy was also the primary end-point in a study of rituximab (RTX) in PR. 86 All of the 33 patients with seropositive PR in this study eventually achieved remission, although some required four cycles of RTX to do so. Neither of these studies were controlled trials.…”

Section: Resultsmentioning

confidence: 73%

EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis

et al. 2021

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BackgroundDespite growing interest, there is no guidance or consensus on how to conduct clinical trials and observational studies in populations at risk of rheumatoid arthritis (RA).MethodsAn European League Against Rheumatism (EULAR) task force formulated four research questions to be addressed by systematic literature review (SLR). The SLR results informed consensus statements. One overarching principle, 10 points to consider (PTC) and a research agenda were proposed. Task force members rated their level of agreement (1–10) for each PTC.ResultsEpidemiological and demographic characteristics should be measured in all clinical trials and studies in at-risk individuals. Different at-risk populations, identified according to clinical presentation, were defined: asymptomatic, musculoskeletal symptoms without arthritis and early clinical arthritis. Study end-points should include the development of subclinical inflammation on imaging, clinical arthritis, RA and subsequent achievement of arthritis remission. Risk factors should be assessed at baseline and re-evaluated where appropriate; they include genetic markers and autoantibody profiling and additionally clinical symptoms and subclinical inflammation on imaging in those with symptoms and/or clinical arthritis. Trials should address the effect of the intervention on risk factors, as well as progression to clinical arthritis or RA. In patients with early clinical arthritis, pharmacological intervention has the potential to prevent RA development. Participants’ knowledge of their RA risk may inform their decision to participate; information should be provided using an individually tailored approach.ConclusionThese consensus statements provide data-driven guidance for rheumatologists, health professionals and investigators conducting clinical trials and observational studies in individuals at risk of RA.

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Section: Resultsmentioning

confidence: 73%

EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis

et al. 2021

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“…Rituximab (RTX) is the first biologic drug used for the treatment of PR. In a retrospective study, 33 patients with PR with more than four attacks in a month, despite at least 3 months of treatment with conventional DMARDs (cDMARDs), were included 46 . All the patients were ACPA and/or RF positive, and the mean duration of treatment with cDMARDs was 22 months.…”

Section: Resultsmentioning

confidence: 99%

“…for the treatment of PR, progression to other diseases was not reported. 46 In our previous report, we have shown that by defining a target for treatment (complete remission) and using a combination of DMARDs with a tight control strategy, less than 10% of patients with PR progress to chronic arthritis during 33 months. 28 Considering the risk factors for evolution of PR to RA may help determine the treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Treatment of palindromic rheumatism: A systematic review

et al. 2021

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Palindromic rheumatism (PR) is an intermittent disease characterised by recurrent and self-resolving attacks of inflammation in the articular and peri-articular tissues. Attacks usually are monoarticular and last from a few hours to a few days. 1 During attacks, patients are asymptomatic. 1 Attacks mostly involve the knees, wrists, metacarpophalangeal joints and proximal interphalangeal (PIP) joints. 1 Finding autoantibodies associated with rheumatoid arthritis (RA) in a large percentage of patients with PR is an interesting feature of this disease. 2,3 In most reports, the frequency of positive rheumatoid factor (RF) and anticyclic citrullinated peptide (anti-CCP) in patients with PR is similar to RA. 2,3 Two recent studies reported two other autoantibodies, antimutated citrullinated vimentin (anti-MCV) in 70% and anticarbamylated protein/peptide antibodies (anti-CarP) in 24% of PR patients. 4,5 PR is an important disease despite the little attention paid to it. Firstly, PR is a relatively common disease. Pasero and Barbieri reported that the frequency of PR was 5% of RA. 6 Powel et al reported more prevalence of PR and concluded that for each of the

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“…Methotrexate, the most widely-used drug in the treatment of RA, has not been tested in PR, although a recent observational, uncontrolled study used methotrexate as part of a treat-to-target strategy that resulted in substantial clinical benefits, with low rates of progression to RA (39). A surprisingly high rate of clinical response was observed with rituximab in an Indian survey (40). Colchicine is effective in seronegative PR patients with MEFV mutations (30).…”

Section: Management and Therapymentioning

confidence: 99%

Palindromic Rheumatism: Just a Pre-rheumatoid Stage or Something Else?

et al. 2021

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Palindromic rheumatism (PR), a unique clinical entity, has a characteristic clinical presentation with a relapsing/remitting course. It is established that most patients with PR evolve to chronic disease, of which rheumatoid arthritis (RA) is by far the most common. The relationship between PR and RA is unclear, with similarities and differences between the two, and not all patients evolve to RA in the long-term. Therefore, PR is clearly a pre-RA stage for most, but not all, patients. Autoimmunity plays a substantial role in PR, with the same characteristic autoantibody profile observed in RA, although with some differences in the immune response repertoire. Autoinflammation may also be relevant in some cases of PR. Prognostic factors for RA progression are identified but their exact predictive value is not clear. There are several unmet needs in PR, such as the diagnostic criteria and clinical case definition, the pathogenic mechanisms involved in the unusual clinical course, and the evolution to RA, and our understanding of the therapeutic strategy that could best avoid progression to persistent and potentially destructive arthritis.

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Efficacy of rituximab in resistant palindromic rheumatism: first report in literature

Cited by 12 publications

References 9 publications

EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis

EULAR points to consider for conducting clinical trials and observational studies in individuals at risk of rheumatoid arthritis

Treatment of palindromic rheumatism: A systematic review

Palindromic Rheumatism: Just a Pre-rheumatoid Stage or Something Else?

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