Monoclonal antibody treatment of mixed cryoglobulinemia resistant to interferon α with an anti-CD20

Sansonno, Domenico; Re, Vallì De; Lauletta, Gianfranco; Tucci, Felicia Anna; Boiocchi, Mauro; Dammacco, Franco

doi:10.1182/blood-2002-10-3162

Cited by 353 publications

(227 citation statements)

References 44 publications

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“…Glomerulonephritis responded within the first three months of treatment. Skin ulcers usually improved within three months after the beginning of RTX therapy, but complete healing required a longer time [37], [38] and [40]. Both sensory and motor neuropathy improved 1-5 months after RTX [38], [40], [41] and [51].…”

Section: Mixed Cryoglobulinemia-associated Glomerulonephritismentioning

confidence: 99%

“…Encouraging results have been obtained in open-label studies and single case reports. RTX improves or cures various clinical manifestations of MC, including fatigue, purpura and skin ulcers, arthralgias and arthritis, glomerulonephritis (in about 90% of cases), peripheral neuropathy (in about 75% of cases), and hyperviscosity syndrome [37], [38], [39], [40], [41], [42], [43], [44], [45], [46], [47], [48], [49], [50] and [51]. RTX was also reported to be effective in some life-threatening cases of gastrointestinal vasculitis [43].…”

Section: Mixed Cryoglobulinemia-associated Glomerulonephritismentioning

confidence: 99%

“…Skin ulcers usually improved within three months after the beginning of RTX therapy, but complete healing required a longer time [37], [38] and [40]. Both sensory and motor neuropathy improved 1-5 months after RTX [38], [40], [41] and [51]. Interestingly, RTX therapy exerted a steroid-sparing effect on MC [37], and some patients, including cases with active nephritis, were treated ab initio without steroids [39].…”

Section: Mixed Cryoglobulinemia-associated Glomerulonephritismentioning

confidence: 99%

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Rituximab-based novel strategies for the treatment of immune-mediated glomerular diseases

Kattah¹,

Fervenza²,

Roccatello³

2013

Autoimmunity Reviews

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Rituximab is a monoclonal antibody to the CD20 antigen on B-cells that was initially designed and approved for the treatment of non-Hodgkin's B-cell lymphoma in 1997.In the last 15 years, it has emerged as a potent immunosuppressant for many immune-mediated diseases, beginning initially with rheumatoid arthritis, and now extending into several other fields, including clinical nephrology. Based on recent large clinical trials, it is FDA-approved for the treatment of ANCA-associated vasculitis and continues to be studied in off-label usage for many glomerular diseases, including membranous nephropathy, lupus nephritis, and mixed cryoglobulinemia. It has been used as a treatment in nephrotic syndrome in children and adults, including both minimal change disease and focal segmental glomerulosclerosis. Given its efficacy, tolerability and safety profile in comparison to more conventional treatment regimens, RTX is rapidly emerging as a critical treatment modality in glomerular disease.

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Section: Mixed Cryoglobulinemia-associated Glomerulonephritismentioning

confidence: 99%

Section: Mixed Cryoglobulinemia-associated Glomerulonephritismentioning

confidence: 99%

Section: Mixed Cryoglobulinemia-associated Glomerulonephritismentioning

confidence: 99%

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Rituximab-based novel strategies for the treatment of immune-mediated glomerular diseases

Kattah¹,

Fervenza²,

Roccatello³

2013

Autoimmunity Reviews

View full text Add to dashboard Cite

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“…63 Rituximab, a chimeric monoclonal antibody directed against CD 20 has been shown to be effective in CV refractory to antiviral regimens. [64][65][66] Numerous case reports and case series have documented the safety and efficacy of rituximab in CV. 67 Rituximab also has a steroid sparing effect and there are reports of patients being treated without, or with very short course of glucocorticoids.…”

Section: Management Of Mixed Cryoglobulinemiamentioning

confidence: 99%

Hepatotropic Viral Infection Associated Systemic Vasculitides—Hepatitis B Virus Associated Polyarteritis Nodosa and Hepatitis C Virus Associated Cryoglobulinemic Vasculitis

Sharma

2013

Journal of Clinical and Experimental Hepatology

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Two hepatotropic viruses have been shown to have causal relationship with systemic vasculitis-hepatitis B with classical polyarteritis nodosa and hepatitis C with cryoglobulinemic vasculitis. The present paper provides an updated overview on the clinical presentations and management of these vasculitides.HBV associated PAN patients have higher weight loss, peripheral neuropathy, mononeuritis multiplex, abdominal pain, gastrointestinal manifestations requiring surgery, cardiomyopathy, orchitis, hypertension, and/or elevated transaminase levels. Microaneurysms are also more common in mesenteric artery. Skin manifestations, however are less common. These patients also have a severe disease as suggested by higher five factor score and higher BVAS. Though relapses are less common, mortality is higher in patients with HBV PAN as compared to non HBV PAN. Plasmapheresis has a role in treatment in clearing off immune complexes.The common clinical manifestations of HCV associated cryoglobulinemic vasculitis are skin lesions, peripheral neuropathy, glomerulonephritis, arthritis, and sicca symptoms. Though combination therapy comprising of pegylated interferon a and ribavirin is the first line of management, immunotherapy is needed for severe or life threatening manifestations. Recent randomized trials have shown the efficacy of rituximab in such situations. ( J CLIN EXP HEPATOL 2013;3:204-212)

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“…Case reports and small clinical trials with this agent in patients with HCV-associated cryoglobulinemic vasculitis have indicated favorable short-term clinical responses without significant hepatotoxicity, although elevation of HCV RNA levels during treatment was noted in some patients (52)(53)(54).…”

Section: Hepatitis C Virusmentioning

confidence: 99%

Viral infection and reactivation in autoimmune disease

Chakravarty

2008

Arthritis & Rheumatism

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Monoclonal antibody treatment of mixed cryoglobulinemia resistant to interferon α with an anti-CD20

Cited by 353 publications

References 44 publications

Rituximab-based novel strategies for the treatment of immune-mediated glomerular diseases

Rituximab-based novel strategies for the treatment of immune-mediated glomerular diseases

Hepatotropic Viral Infection Associated Systemic Vasculitides—Hepatitis B Virus Associated Polyarteritis Nodosa and Hepatitis C Virus Associated Cryoglobulinemic Vasculitis

Viral infection and reactivation in autoimmune disease

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