Successful Use of Rituximab in Recalcitrant Skin Predominant Dermatomyositis

Joshi, Nilay; Nautiyal, Amit; Davies, Paul

doi:10.1097/rhu.0b013e31821072b7

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…The treatment of patients with shorter disease duration seems to be associated with a better outcome, in particular when treatment was started in patients with a disease duration shorter than 36 months. Literature data confirm our observations about the good efficacy in DM patients (24)(25)(26)(27), in particular in patients with the juvenile form (28). Several studies also reported a good outcome in patients with lung disease, in particular when associated with antisynthetase autoantibodies positivity (13,(29)(30)(31)(32)(33)(34).…”

Section: Original Paper N Discussion and Conclusionsupporting

confidence: 88%

The use of rituximab in idiopathic inflammatory myopathies: description of a monocentric cohort and review of the literature

et al. 2018

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Rituximab (RTX), a chimeric monoclonal antibody targeted against CD20, has been used to treat refractory inflammatory myopathies (IIM). The primary objective of this study was to retrospectively assess the efficacy of RTX in reducing disease activity in patients with IIM refractory to conventional therapy. Secondary aim was the evaluation of adverse events (AE) during the treatment period. We examined 26 patients with a diagnosis of IIM, referred to our Rheumatology Unit and treated with RTX for active refractory disease. Patients were treated with RTX 1000 mg i.v., twice, with a 2-week interval. RTX treatment was associated with a significant reduction of creatine kinase (p=0.001) after six months compared to the baseline, an improved muscular strength measured with MMT8 (p<0.001) and a reduction of the extramuscular activity of the disease measured with MYOACT (p<0.001). In particular, RTX improved DM skin rash, arthritis and pulmonary manifestations. Autoantibody positivity (in particular antisynthetase, anti- SRP and antiRo/SSA), and a disease duration <36 months at the moment of the treatment are associated with a better response rate. Treatment with RTX was also associated with a reduction of the mean daily dose of steroids needed to control disease activity (p=0.002). Our results have confirmed that RTX is efficacious in the treatment of refractory IIM. Ad hoc controlled trials are needed to better clarify the specific subset of patients who may better respond to the treatment and the optimal therapeutic schedule.

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Section: Original Paper N Discussion and Conclusionsupporting

confidence: 88%

The use of rituximab in idiopathic inflammatory myopathies: description of a monocentric cohort and review of the literature

et al. 2018

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“…The use of thalidomide, high-dose immunoglobulins or immunosuppressive agents such as MMF, azathioprine, methotrexate, cyclophosphamide, cyclosporine A, oral tacrolimus, or biological agents such as etanercept or infliximab have also been reported with various success. Rituximab has been used in polymyositis, DM and the antisynthetase syndrome in the attempt to control muscle and lung disease, but also predominant skin involvement [23,24]. To the best of our knowledge, our case is the first example of response to rituximab, in MDA5-related CADM.…”

Section: Discussionmentioning

confidence: 96%

Response of Mucocutaneous Lesions to Rituximab in a Case of Melanoma Differentiation Antigen 5-Related Dermatomyositis

Clottu¹,

Laffitte²,

Prins³

et al. 2012

Dermatology

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We report the first case in Western Europe of a person presenting with dermatomyositis associated with melanoma differentiation antigen 5 antibodies. She sequentially developed severe mucocutaneous erythematous and itchy lesions of the face, scalp, neck, knees and recurrent aphthae. In addition she presented painful, periungual, edematous digital lesions and small ulcers with digital necrosis. Her rapidly evolving, near-fatal interstitial lung disease responded to high-dose intravenous cyclophosphamide. However, her recurrent mucocutaneous mani-festations improved only after rituximab administration.

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“…It seems there is a favorable trend in patients with myositis-specific antibodies including anti-Jo1, which appears in keeping with the mechanism of action of the drug [Frikha et al 2009]. There is particular note of successful use with skin-predominant DM [Joshi et al 2011], and in ILD in the antisynthetase syndrome [Sem et al 2009]. In one case report [Vandenbroucke et al 2009], ILD which was the remaining unresponsive aspect of the disease responded favorably to rituximab initiation.…”

Section: Rituximabmentioning

confidence: 99%

Novel approaches in the treatment of myositis and myopathies

Albayda

Christopher‐Stine

2012

Therapeutic Advances in Musculoskeletal

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The inflammatory myopathies are a heterogeneous group of disorders characterized by muscle weakness and inflammation. Although no standard therapeutic guidelines exist, traditional treatment has included corticosteroids and a variety of second-line immunosuppressants. As treatment of refractory disease has been difficult, newer agents and approaches have been used with varying response. The advent of standardized treatment response criteria by the International Myositis Assessment and Clinical Studies (IMACS) group has helped investigators to evaluate and compare clinical trial outcomes in a more rigorous fashion. The use of intravenous immunoglobulin (IVIG), rituximab, biologic agents including tumor necrosis factor (TNF) inhibitors, stem-cell transplantation, gene therapy, and vascular occlusion resistance training are reviewed here. As our understanding of disease pathogenesis at the immunologic, genetic, and molecular level expands, the discovery of novel therapeutic targets hold promise for the successful treatment of these conditions.

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Successful Use of Rituximab in Recalcitrant Skin Predominant Dermatomyositis

Cited by 5 publications

References 8 publications

The use of rituximab in idiopathic inflammatory myopathies: description of a monocentric cohort and review of the literature

The use of rituximab in idiopathic inflammatory myopathies: description of a monocentric cohort and review of the literature

Response of Mucocutaneous Lesions to Rituximab in a Case of Melanoma Differentiation Antigen 5-Related Dermatomyositis

Novel approaches in the treatment of myositis and myopathies

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