Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases

Gottenberg, J.E.; Guillevin, Loı̈c; Lambotte, O.; Combe, Bernard; Allanore, Yannick; Cantagrel, A.; Larroche, Claire; Soubrier, Martin; Bouillet, Laurence; Dougados, Maxime; Fain, Olivier; Farge, D.; Kyndt, X.; Lortholary, O.; Masson, Charles; Moura, B; Remy, P; Thomas, Thommey P.; Wendling, Daniel; Anaya, Juan Manuel; Sibilia, Jean; Mariette, Xavier

doi:10.1136/ard.2004.029694

Cited by 352 publications

(240 citation statements)

References 20 publications

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“…Initial data have shown rituximab to be efficacious and relatively safe in the treatment of systemic diseases such as RA, Wegener's granulomatosis, and SLE (7,9,23). Although SS is considered to be a T cell-mediated disease, its systemic complications are associated with increased B cell activity.…”

Section: Discussionmentioning

confidence: 99%

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Pijpe

Imhoff²,

Spijkervet

et al. 2005

Arthritis & Rheumatism

447

300

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Objective. To investigate the safety and efficacy of B cell depletion treatment of patients with active primary Sjögren's syndrome of short duration (early primary SS) and patients with primary SS and mucosaassociated lymphoid tissue (MALT)-type lymphoma (MALT/primary SS).Methods. Fifteen patients with primary SS were included in this phase II trial. Inclusion criteria for the early primary SS group were B cell hyperactivity (IgG >15 gm/liter), presence of autoantibodies (IgM rheumatoid factor, anti-SSA/SSB), and short disease duration (<4 years). Inclusion criteria for the MALT/ primary SS group were primary SS and an associated MALT-type lymphoma (Ann Arbor stage IE) localized in the parotid gland. Patients were treated with 4 infusions of rituximab (375 mg/m 2 ) given weekly after pretreatment with prednisone (25 mg) and clemastine. Patients were evaluated, using immunologic, salivary/ lacrimal function, and subjective parameters, at baseline and at 5 and 12 weeks after the first infusion.Results. Significant improvement of subjective symptoms and an increase in salivary gland function was observed in patients with residual salivary gland function. Immunologic analysis showed a rapid decrease of peripheral B cells and stable levels of IgG. Human antichimeric antibodies (HACAs) developed in 4 of 15 patients (27%), all with early primary SS. Three of these patients developed a serum sickness-like disorder. Of the 7 patients with MALT/primary SS, complete remission was achieved in 3, and disease was stable in 3 and progressive in 1.Conclusion. Findings of this phase II study suggest that rituximab is effective in the treatment of primary SS. The high incidence of HACAs and associated side effects observed in this study needs further evaluation.

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Section: Discussionmentioning

confidence: 99%

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Pijpe

Imhoff²,

Spijkervet

et al. 2005

Arthritis & Rheumatism

447

300

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“…The first use of RTX to induce remission in a patient with refractory and frequently relapsing AAV was reported by Specks et al in 2001 [15]. Subsequently, a number of reports documented the clinical benefits of RTX given in addition to cyclophosphamide, methotrexate, azathioprine or mycophenolate mofetil [11], [16], [17] and [18]. In general, clinical remission has been reported in about 80% of cases by 6 months [19] and one of the significant benefits is that patients can often be titrated off other immunosuppressants, including corticosteroids, after receiving RTX [11].…”

Section: Anti-neutrophil Cytoplasmic Antibody (Anca)-associated Smallmentioning

confidence: 99%

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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“…Regarding ethnic factors, the 2 RCTs included American patients, predominantly from the US and Canada, but also from Mexico, Brazil, and Argentina. However, the majority of patients from recent uncontrolled studies were European (1,6,7,9,11,12). This ethnicity is important because some studies have suggested a variable therapeutic response to the main immunosuppressive agents in different ethnic groups (13).…”

Section: To the Editorsmentioning

confidence: 99%

Rituximab and lupus: Good in real life, bad in controlled trials. comment on the article by Lu et al

Ramos‐Casals

Díaz-Lagares

Khamashta

2009

Arthritis & Rheumatism

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Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases

Cited by 352 publications

References 20 publications

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

Rituximab treatment in patients with primary Sjögren's syndrome: An open‐label phase II study

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

Rituximab and lupus: Good in real life, bad in controlled trials. comment on the article by Lu et al

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