Rituximab for non-infectious Uveitis and Scleritis

Ng, Caleb; Sy, Aileen; Cunningham, Emmett T.

doi:10.1186/s12348-021-00252-4

Cited by 28 publications

(12 citation statements)

References 78 publications

(178 reference statements)

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“…105 It produces a positive therapeutic response by depleting the CD20 + B cells that attack various segments of the eye, including disease improvement and remission, which translates into improved visual acuity. 104,106–120…”

Section: Resultsmentioning

confidence: 99%

Repurposing of rituximab biosimilars to treat B cell mediated autoimmune diseases

Mostkowska,

Rousseau,

Raynal

2023

Preprint

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Rituximab, the first monoclonal antibody approved for the treatment of lymphoma, eventually became one of the most popular and versatile drugs ever in terms of clinical application and revenue. Since its patent expiration, and consequently, the loss of exclusivity of the original biologic, its repurposing as an off-label drug has increased dramatically, propelled by the development and commercialization of its many biosimilars. Currently, rituximab is prescribed worldwide to treat a vast range of autoimmune diseases mediated by B cells. Here, we present a comprehensive overview of rituximab repurposing in 116 autoimmune diseases across 17 medical specialties, sourced from over 1,530 publications. Our work highlights the extent of its off-label use and clinical benefits, underlining the success of rituximab repurposing for both common and orphan immune-related diseases. We discuss the scientific mechanism associated with its clinical efficacy and provide additional indications for which rituximab could be investigated. Our study presents rituximab as a flagship example of drug repurposing owing to its central role in targeting CD20+ B cells in over 100 autoimmune diseases.

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Section: Resultsmentioning

confidence: 99%

Repurposing of rituximab biosimilars to treat B cell mediated autoimmune diseases

Mostkowska,

Rousseau,

Raynal

2023

Preprint

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“…The mean terminal half-life is approximately 22 days. A growing number of reports have supported the use of rituximab in some types of NIU [ 50 , 51 , 52 , 53 , 54 , 55 ]. A retrospective study in JIA-associated uveitis showed a decrease in uveitis recurrences in patients who have not previously responded to other biologic therapies [ 50 ].…”

Section: Biologics In Uveitis Treatmentmentioning

confidence: 99%

Perspectives of Therapeutic Drug Monitoring of Biological Agents in Non-Infectious Uveitis Treatment: A Review

et al. 2023

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Biological drugs, especially those targeting anti-tumour necrosis factor α (TNFα) molecule, have revolutionized the treatment of patients with non-infectious uveitis (NIU), a sight-threatening condition characterized by ocular inflammation that can lead to severe vision threatening and blindness. Adalimumab (ADA) and infliximab (IFX), the most widely used anti-TNFα drugs, have led to greater clinical benefits, but a significant fraction of patients with NIU do not respond to these drugs. The therapeutic outcome is closely related to systemic drug levels, which are influenced by several factors such as immunogenicity, concomitant treatment with immunomodulators, and genetic factors. Therapeutic drug monitoring (TDM) of drug and anti-drug antibody (ADAbs) levels is emerging as a resource to optimise biologic therapy by personalising treatment to bring and maintain drug concentration within the therapeutic range, especially in those patients where a clinical response is less than expected. Furthermore, some studies have described different genetic polymorphisms that may act as predictors of response to treatment with anti-TNFα agents in immune-mediated diseases and could be useful in personalising biologic treatment selection. This review is a compilation of the published evidence in NIU and in other immune-mediated diseases that support the usefulness of TDM and pharmacogenetics as a tool to guide clinicians’ treatment decisions leading to better clinical outcomes. In addition, findings from preclinical and clinical studies, assessing the safety and efficacy of intravitreal administration of anti-TNFα agents in NIU are discussed.

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“…It is essential to rule out underlying demyelinating or malignant disease before anti-TNF initiation. Rescue drugs are not well studied for patients' refractory to MMF, MTX, and anti-TNF therapy but may include tocilizumab, JAK inhibitors, or rituximab, depending on the disease [43][44][45][46].…”

Section: Uveitis Treatmentmentioning

confidence: 99%

Inflammatory eye disease for rheumatologists

Corbitt

Nowatzky

2023

Current Opinion in Rheumatology

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Purpose of reviewThis review provides a framework for understanding inflammatory eye disease diagnosis, differential diagnosis, and management for rheumatologists. Uveitis, scleritis, episcleritis, peripheral ulcerative keratitis, and orbital inflammation are all discussed. The goal is to facilitate the development of approaches to inflammatory eye diseases that will help rheumatologists co-manage these patients with eye care providers specializing in ocular inflammation.Recent findingsIn recent years, studies have aimed to advance biologic treatments and define standard-of-care therapy. Inflammatory eye diseases are highly heterogeneous and often rare, which poses significant challenges to their research and the interpretation of existing data. To date, glucocorticoids, mycophenolate, methotrexate, and TNF inhibitors remain the mainstay of treatment options for many of these diseases.SummaryPatients with inflammatory eye diseases require multidisciplinary care for best outcomes, frequently including rheumatologists. Understanding the differentials, diagnostics, and treatment are essential to preserving vision in these patients. The diverse nature of the disease processes within this field requires focusing on specific disease phenotypes and endotypes in research and clinical practice.

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Rituximab for non-infectious Uveitis and Scleritis

Cited by 28 publications

References 78 publications

Repurposing of rituximab biosimilars to treat B cell mediated autoimmune diseases

Repurposing of rituximab biosimilars to treat B cell mediated autoimmune diseases

Perspectives of Therapeutic Drug Monitoring of Biological Agents in Non-Infectious Uveitis Treatment: A Review

Inflammatory eye disease for rheumatologists

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