Successful Use of Rituximab for Cutaneous Vasculitis

Chung, Lorinda

doi:10.1001/archderm.142.11.1407

Cited by 37 publications

(13 citation statements)

References 25 publications

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“…Rituximab treatment has also demonstrated to be effective in seronegative AIDs, as for example cutaneous vasculitis and ANCA-negative vasculitis. 60,61,62 Autoimmune encephalitis is a rare but dreadful irAE that is often associated with double checkpoint blockade, as reported in different tumor types. Cases have been reported in which anti-neural autoantibodies were detected, such as anti-NMDAR 63 or anti-Hu 64 ; in other cases, such antibodies were undetectable.…”

Section: Anti-b-cell Strategymentioning

confidence: 99%

New therapeutic perspectives to manage refractory immune checkpoint-related toxicities

Martins

Sykiotis

Maillard

et al. 2019

The Lancet Oncology

155

153

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Immune-checkpoint inhibitors (ICIs) are reshaping the prognosis of many cancer types and are progressively becoming a standard of care for many of them. Cancer immunotherapy has started a revolution in the oncology therapeutic landscape, bringing new hope to patients but also a whole new spectrum of toxicities for practitioners to manage. Oncologists and specialists involved in the pluridisciplinary management of immune-related adverse events (irAEs) are increasingly confronted with the therapeutic challenge of severe and/or refractory cases. In this personal view, we summarize the therapeutic strategies reported to manage them. Based on current knowledge of irAE pathogenesis and our immunological expertise, we also transpose the use of new biologic and non-biologic immunosuppressive agents, used to treat primary autoimmune disorders (AIDs), in the context of severe and/or steroid refractory irAE management. Depending on the immune-type predominant infiltrate, we propose a personalized treatment algorithm beyond corticosteroids. A shut-off strategy, intended to treat severe or steroid-refractory irAEs, based on the efficient inhibition of key inflammatory components involved in their pathophysiological processes, and limit potential adverse effects of drug immunosuppression on tumor response is proposed. This approach goes beyond current guidelines, challenging the step-by-step increase in drug immunosuppression proposed so far.

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Section: Anti-b-cell Strategymentioning

confidence: 99%

New therapeutic perspectives to manage refractory immune checkpoint-related toxicities

Martins

Sykiotis

Maillard

et al. 2019

The Lancet Oncology

155

153

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“…Low levels of serum complement, positive serum cryoglobulins, and high ESR may call for a diagnosis of cryoglobulinemia secondary to chronic hepatitis C [11], such as in Case 3, who also had LV + cryoglobulinemia + HCV. The LV was treated with steroid alone, without at the same time addressing the HCV.…”

Section: Discussionmentioning

confidence: 99%

Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis

Karatoprak

Arabaci

Yıldız

et al. 2013

Case Reports in Medicine

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Rarely, leukocytoclastic vasculitis can result from ischemic colitis, inflammatory bowel disease, and cryoglobulinemia. There is no established standard for the treatment of leukocytoclastic vasculitis associated with gastroenterologic diseases. This paper presents three cases of leukoytoclastic vasculitis, each of which is associated with a different gastroenterologic condition: ischemic colitis, Crohn's disease, and chronic hepatitis C. Each condition went into remission by treatment of leukocytoclastic vasculitis, regardless of the underlying disease.

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“…In 2006, Chung et al [10] used rituximab to treat 2 cases of severe and progressive cutaneous vasculitis. The first was a transplant patient who presented with skin lesions and renal failure.…”

Section: Discussionmentioning

confidence: 99%

Rituximab Therapy for Severe Cutaneous Leukocytoclastic Angiitis Refractory to Corticosteroids, Cellcept and Cyclophosphamide

El-Reshaid

Madda

2013

Case Rep Dermatol

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We report our clinical experience with rituximab in the treatment of 2 patients with idiopathic cutaneous angiitis who relapsed after treatment with high-dose corticosteroids and cyclophosphamide. A 39-year-old woman and a 51-year-old man presented with ulcerating maculopapular rash in both lower limbs which relapsed 6 months after treatment with a combination of high-dose corticosteroids and cyclophosphamide. After treatment with 2 g of rituximab, the first patient has still been in clinical remission for 32 months while the second has finished 28 months. Interestingly, CD19 which had dropped to <0.1 one week following the start of retuximab had increased to >0.5% 8 months later in both patients. Despite that, our patients are still in clinical remission. No significant side effects were noted during infusions and up to the period of follow-up. In conclusion, rituximab is a useful and safe agent in the treatment of idiopathic cutaneous angiitis refractory to conventional therapy. Clinical remission persists years after improvement of B-cell suppression.

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Successful Use of Rituximab for Cutaneous Vasculitis

Cited by 37 publications

References 25 publications

New therapeutic perspectives to manage refractory immune checkpoint-related toxicities

New therapeutic perspectives to manage refractory immune checkpoint-related toxicities

Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis

Rituximab Therapy for Severe Cutaneous Leukocytoclastic Angiitis Refractory to Corticosteroids, Cellcept and Cyclophosphamide

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