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
- PMID: 16950808
- PMCID: PMC1856024
- DOI: 10.1136/ard.2006.057919
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.
Conflict of interest statement
Competing interests: None.
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References
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