Tolerance and efficacy of rituximab and changes in serum B cell biomarkers in patients with systemic complications of primary Sjögren's syndrome - PubMed (original) (raw)

Multicenter Study

doi: 10.1136/ard.2006.057919. Epub 2006 Sep 1.

Christelle Sordet, Loic Guillevin, Eric Hachulla, Charles Masson, Marc Ittah, Sophie Candon, Véronique Le Guern, Achille Aouba, Jean Sibilia, Jacques-Eric Gottenberg, Xavier Mariette

Affiliations

Multicenter Study

Tolerance and efficacy of rituximab and changes in serum B cell biomarkers in patients with systemic complications of primary Sjögren's syndrome

Raphaèle Seror et al. Ann Rheum Dis. 2007 Mar.

Abstract

Objective: To investigate the safety and efficacy of rituximab (RTX) for systemic symptoms in patients with primary Sjögren's syndrome (pSS), and changes in B cell biomarkers.

Patients and methods: The records of 16 patients with pSS according to the American European consensus group criteria were reviewed retrospectively.

Results: Patients, all women, had a median age of 58.5 (range 41-71) years and a disease duration of 9.5 (range 0-25) years. RTX was prescribed for lymphoma (n = 5), refractory pulmonary disease with polysynovitis (n = 2), severe polysynovitis (n = 2), mixed cryoglobulinaemia (n = 5), thrombocytopenia (n = 1) and mononeuritis multiplex (n = 1). The median follow-up duration was 14.5 (range 2-48) months. Three patients experienced adverse events, including one mild serum sickness-like reaction with the presence of human antichimeric antibodies. Efficacy of treatment was observed in 4 of 5 patients with lymphomas and in 9 of 11 patients with systemic involvement. Dryness was improved in only a minority of patients. Corticosteroid dose was reduced in 11 patients. RTX induced decreased rheumatoid factor, gamma-globulin and beta2-microglobulin levels, and the level of B cell activating factor of the tumour necrosis factor family (BAFF) increased concomitantly with B cell depletion. Five patients were re-treated, with good efficacy and tolerance, except for one with probable serum sickness-like reaction.

Conclusion: This study shows good efficacy and fair tolerance of RTX for systemic features. In addition, RTX allows for a marked reduction in corticosteroid use. Except for BAFF, the level of which increases, serum B cell biomarker levels decrease after taking RTX. Controlled trials should be performed to confirm the efficacy of RTX in pSS.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None.

Figures

References

    1. Hansen A, Lipsky P E, Dorner T. New concepts in the pathogenesis of Sjogren syndrome: many questions, fewer answers. Curr Opin Rheumatol 200315563–570. - PubMed
    1. Bohnhorst J O, Bjorgan M B, Thoen J E, Natvig J B, Thompson K M. Bm1‐Bm5 classification of peripheral blood B cells reveals circulating germinal center founder cells in healthy individuals and disturbance in the B cell subpopulations in patients with primary Sjogren's syndrome. J Immunol 20011673610–3618. - PubMed
    1. Lavie F, Miceli‐Richard C, Quillard J, Roux S, Leclerc P, Mariette X. Expression of BAFF (BLyS) in T cells infiltrating labial salivary glands from patients with Sjogren's syndrome. J Pathol 2004202496–502. - PubMed
    1. Gottenberg J E, Cagnard N, Lucchesi C, Letourneur F, Mistou S, Lazure T.et al Activation of IFN pathways and plasmacytoid dendritic cell recruitment in target organs of primary Sjogren's syndrome. Proc Natl Acad Sci USA 20061032770–2775. - PMC - PubMed
    1. Gottenberg J E, Busson M, Cohen‐Solal J, Lavie F, Abbed K, Kimberly R P.et al Correlation of serum B lymphocyte stimulator and beta2 microglobulin with autoantibody secretion and systemic involvement in primary Sjogren's syndrome. Ann Rheum Dis 2005641050–1055. - PMC - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources