Treatment of relapsing polychondritis with rituximab: A retrospective study of nine patients

Abstract

Objective. Rituximab, a chimeric monoclonal antibody directed against the CD20 antigen expressed by B cells, is now considered an effective second-line therapy in various systemic diseases. We describe here the effects of rituximab in patients with relapsing polychondritis. Methods. This was a retrospective study of 9 patients with relapsing polychondritis who received different regimens of rituximab in addition to their ongoing therapies. Clinical, laboratory, physiologic, and radiologic indicators were used to assess disease activity. We also examined their corticosteroid doses and any change in immunosuppressive agents. We then compared disease activity in the 6 months preceding rituximab administration and at 6 and 12 months after. Results. At 6 months, 2 patients showed partial improvement, 4 were stable, and 3 had worsened disease; however, no patient had complete remission. At 12 months (after exclusion of the 3 patients whose disease had worsened at 6 months), 2 patients remained stable and 4 had worsened disease; however, there were no partial or complete remissions. B cells were counted in 8 patients during the first 6 months after treatment, and B cell depletion was observed in all of the patients. Conclusion. Although we cannot rule out the possibility that rituximab had a small effect, our patients' clinical courses did not improve significantly with this treatment.

Relapsing polychondritis: a description of a case and review article

“…Leroux et al [53] described nine patients with refractory disease, all of whom had received prior treatment with corticosteroids and a variety of immunosuppressive agents. Analysis at 6 and 12 months after initiation of rituximab revealed that no patient achieved complete remission, while some were stable and others deteriorated.…”

Relapsing polychondritis: a review

“…There are isolated case reports of favourable response to rituximab in patients not responding to immunosuppressive therapy [78,79]. However, a retrospective study [80] of 9 patients treated with rituximab showed that at the end of 12 months of therapy, no patient was in partial or complete remission though depletion of B cells was demonstrated. Anti-TNF agents have been used successfully in patients with refractory RP.…”

Rezidivierende Polychondritis

“…Die Hemmung von Interleukinen scheint sich insbesondere bei Organbeteiligung positiv auf die Krankheitsaktivität auszuwirken. Ferner werden aktuell mehr Fallberichte zu einem positiven Einsatz von Rituximab zur B-ZellDepletion veröffentlicht [22]. Darüber hinaus gibt es auch limitierte Erfahrungen mit Abatacept [23].…”