Tolerance and efficacy of rituximab and changes in serum B cell biomarkers in patients with systemic complications of primary Sjogren's syndrome
- 1 March 2007
- journal article
- research article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 66 (3), 351-357
- https://doi.org/10.1136/ard.2006.057919
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, γ-globulin and β2-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.Keywords
This publication has 31 references indexed in Scilit:
- Long term remission of Sjogren's syndrome associated aggressive B cell non-Hodgkin's lymphomas following combined B cell depletion therapy and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone)Annals Of The Rheumatic Diseases, 2006
- Successful treatment of refractory anterior scleritis in primary Sjogren's syndrome with rituximabAnnals Of The Rheumatic Diseases, 2005
- Correlation of serum B lymphocyte stimulator and 2 microglobulin with autoantibody secretion and systemic involvement in primary Sjogren's syndromeAnnals Of The Rheumatic Diseases, 2005
- Letter to the EditorLupus, 2004
- Normalization of anticardiolipin antibodies following rituximab therapy for marginal zone lymphoma in a patient with Sjogren's syndromeRheumatology, 2004
- Combined therapy with rituximab plus cyclophosphamide/doxorubicin/vincristine/prednisone (CHOP) for Sjogren's syndrome-associated B-cell aggressive non-Hodgkin's lymphomasRheumatology, 2004
- Expression of BAFF (BLyS) in T cells infiltrating labial salivary glands from patients with Sjögren's syndromeThe Journal of Pathology, 2004
- Efficacy and safety of rituximab in type II mixed cryoglobulinemiaBlood, 2003
- Rituximab-induced serum sicknessAmerican Journal of Hematology, 2002
- Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European Consensus GroupAnnals Of The Rheumatic Diseases, 2002