Long-term remission of severe refractory dermatopolymyositis with a weekly-scheme of immunoglobulin followed by rituximab therapy

Sánchez-Ramón, Silvia; Ravell, Juan C; Torre, Inmaculada de la; Montoro, María; Rodríguez‐Mahou, Margarita; Carreño-Pérez, Luis; Fernández‐Cruz, Eduardo; López‐Longo, Francisco Javier

doi:10.1007/s00296-009-1000-x

Cited by 12 publications

(1 citation statement)

References 11 publications

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“…Another case series of three patients and a few case reports of DM patients with resistant skin disease showed improvement with rituximab [29]. Based on the above reports, the efficacy of rituximab in the myositis component of DM is more established than the cutaneous response, but the combination of rituximab and IVIG was successful in an additional case [30]. Rituximab yielded mixed results in JDM in a case series of four patients [31].…”

Section: Rituximabmentioning

confidence: 92%

Therapeutic Approaches in Myositis

Aggarwal

Oddis

2011

Curr Rheumatol Rep

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The inflammatory myopathies are a heterogeneous group of diseases including dermatomyositis, polymyositis, and inclusion body myositis. Few clinical trials have been conducted in myositis, making it difficult to provide clear recommendations on the treatment of these rare disorders. Although corticosteroids have not been tested in randomized controlled trials, the general expert consensus confirms their first-line use. However, in many patients, corticosteroid toxicity leads to significant disability, or these agents are ineffective, which then requires additional immunosuppression. Intravenous immunoglobulin is a reasonable short-term treatment with proven benefit in a controlled trial, but its long-term effectiveness remains unknown. The evidence for other immunosuppressive therapies has been derived mainly from case reports and open studies. These agents include methotrexate and/or azathioprine, followed by cyclosporine or tacrolimus (particularly for antisynthetase antibody-positive patients) and mycophenolate mofetil (for refractory rash). Newer therapies (eg, rituximab) are encouraging, but results from the largest randomized controlled trial studying this agent are soon to follow. The balance of evidence suggests that immunosuppressive drugs are effective in dermatomyositis and polymyositis, although randomized controlled trials are lacking.

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Section: Rituximabmentioning

confidence: 92%

Therapeutic Approaches in Myositis

Aggarwal

Oddis

2011

Curr Rheumatol Rep

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B-Cell Targeted Therapies in Systemic Sclerosis and Inflammatory Myopathies

Aggarwal

Nagaraja

Khanna

2013

Milestones in Drug Therapy

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Rituximab in refractory idiopathic inflammatory myopathies and antisynthetase syndrome: personal experience and review of the literature

et al. 2013

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In this paper, we report our experience with the use of rituximab (RTX) in the treatment of refractory idiopathic inflammatory myopathies (IIM) and review the literature on this topic. Six adult patients (5 female, 1 male) with active IIM, as defined by persistent proximal muscle weakness, elevated serum muscle enzymes, muscle magnetic resonance imaging, electromyographic and histological abnormalities, refractory to at least one immunosuppressant, including methotrexate, were treated with RTX (1,000 mg twice, 2 weeks apart). Patients were regularly followed up for serial assessment of muscle strength by manual muscle test 8 and creatine kinase serum levels. Three patients were affected with polymyositis (PM) and three with anti-t-RNA synthetase syndrome (ASS). A complete B-cell depletion was observed in all patients by 3 months after RTX. A significant clinical improvement was observed in 5 out of 6 cases 6 months after RTX. Only one mild infusion reaction and one case of Herpes zoster infection were observed. A review of the literature to find all the available cases of refractory patients affected with IIM from 1980 to 2012, using the PubMed database, was performed. We were able to find 27 papers, 18 on PM and dermatomyositis and 9 on ASS, including 88 and 40 patients, respectively. A significant improvement was observed in 80% of patients overall and the drug was well tolerated in the majority of cases. In conclusion, RTX can be considered a therapeutic option in refractory IIM.

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Long-term remission of severe refractory dermatopolymyositis with a weekly-scheme of immunoglobulin followed by rituximab therapy

Abstract: Mahou, et al.. Long-term remission of severe refractory dermatopolymyositis with a weekly-scheme of immunoglobulin followed by rituximab therapy.

Cited by 12 publications

References 11 publications

Therapeutic Approaches in Myositis

Therapeutic Approaches in Myositis

B-Cell Targeted Therapies in Systemic Sclerosis and Inflammatory Myopathies

Rituximab in refractory idiopathic inflammatory myopathies and antisynthetase syndrome: personal experience and review of the literature

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