Background The treatment of rare autoimmune diseases presents for patients the additional problem of limited therapeutic options, which are usually reduced to corticosteroids and immunosuppressants. The use of rituximab could be an effective alternative.
Purpose To determine the efficacy of treatment with rituximab in autoimmune diseases.
Material and methods Retrospective observational study of patients with autoimmune diseases who were treated with rituximab between January 2008–March 2014. Data was collected from electronic prescription records. Diagnosis, reason for prescribing, previous and concomitant treatments, dose, recurrence and treatment outcome were collected as study variables.
Results 11 patients (36% male), mean age 47 years were analysed. The diseases were lupus erythematosus (36%) autoimmune thrombocytopenia (9%) and a miscellaneous group: vasculitis, pemphigus, scleroderma, cryoglobulinaemia, Sjögren’s syndrome, antiphospholipid syndrome (55%). The reason for using rituximab was: treatment failure with pre-treatments in 81% of cases or first choice in the remaining 19%. 81% of administrations followed the pattern 375 mg/m²/week for 4 weeks while 19% followed the pattern of 1,000 mg on days 1 and 15 of each cycle. With respect to previous treatment, 81% of patients had received high doses of corticosteroids, 54% corticosteroids with immunosuppressant; 1 patient was on prior treatment with intravenous immunoglobulin. Rituximab was administered concomitantly with corticosteroids for the majority of patients (91%). Treatment efficacy was assessed according to the response as: complete response (27%), partial response (54%) and no response (18%). Of the 11 patients studied, 6 (54%) received only one cycle of rituximab, 3 (27%) currently remain in treatment and 2 patients (18%) died due to progression of their disease.
Conclusion Although its efficacy is variable, rituximab may be a valid therapeutic option in autoimmune diseases. Randomised controlled studies are necessary to ensure the various indications of rituximab.
Rosman Z, Shoenfeld Y, Zandman-Goddard G. Biologic therapy for autoimmune diseases: an update. BMC Medicine 2013;11:88
ReferenceNo conflict of interest.
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