Efficacy and safety of rituximab in the treatment of refractory inflammatory myopathies in adults: results from the AIR registry
Open Access
- 22 October 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 50 (12), 2283-2289
- https://doi.org/10.1093/rheumatology/ker305
Abstract
Objectives. To assess the efficacy and safety of rituximab (RTX) in patients with refractory idiopathic inflammatory myopathies (IIMs). Methods. RTX efficacy was based on improvement in three criteria: creatine phosphokinase (CPK) level, daily CS dose and physicians’ opinion. A decrease in CPK level or CS dose was significant if it was >25%. Results. Thirty patients were studied (21 women; age 52.5 years, disease duration 6.1 years). All had previously received immunosuppressors (ISs). Twenty-five patients received 1 g of RTX twice 2 weeks apart and five received 4 weekly RTX infusions (375 mg/m2). RTX was given in association with IS in 21 patients. Twenty-eight patients received CS (mean dose 21.2 mg/day). Mean follow-up was 17.2 months. Thirteen adverse events were reported, including seven infections and one serious infection (pyelonephritis). RTX was effective in 16 patients. Duration of efficacy was 15.5 months. Of the 20 patients with baseline CPK level ≥2 × upper limit of normal (ULN), 11 (55%) improved. The main level fell from 20.7 to 11 × ULN. CS decreased in 15 patients, stopped in 4, remained stable in 8 and increased in the remaining 3. The CS dose decreased from 21.2 to 9.9 mg/day. The physicians’ opinion was favourable in 21 patients. Manual muscle testing was performed in only five patients: it increased from 87 to 91/100 at 6 months. Conclusions. RTX was well tolerated and had some beneficial effects on patients with IIM, the main limitation of this study resulted in a lack of manual muscle testing.Keywords
This publication has 34 references indexed in Scilit:
- Rituximab versus Cyclophosphamide for ANCA-Associated VasculitisNew England Journal of Medicine, 2010
- Effectiveness of rituximab treatment in primary Sjögren's syndrome: A randomized, double‐blind, placebo‐controlled trialArthritis & Rheumatism, 2010
- Rituximab treatment of the anti-synthetase syndrome—a retrospective case seriesRheumatology, 2009
- Poor response of anti-SRP-positive idiopathic immune myositis to B-cell depletionRheumatology, 2008
- Leflunomide as a remission-maintaining therapy in difficult-to-treat dermatomyositisAnnals Of The Rheumatic Diseases, 2007
- Tolerance and efficacy of rituximab and changes in serum B cell biomarkers in patients with systemic complications of primary Sjogren's syndromeAnnals Of The Rheumatic Diseases, 2007
- Long-term outcome in polymyositis and dermatomyositisAnnals Of The Rheumatic Diseases, 2006
- Possible role for tumour necrosis factor inhibitors in the treatment of resistant dermatomyositis and polymyositis: a retrospective study of eight patientsAnnals Of The Rheumatic Diseases, 2006
- Rituximab for rheumatoid arthritis refractory to anti–tumor necrosis factor therapy: Results of a multicenter, randomized, double‐blind, placebo‐controlled, phase III trial evaluating primary efficacy and safety at twenty‐four weeksArthritis & Rheumatism, 2006
- Rituximab in the treatment of antisynthetase syndromeAnnals Of The Rheumatic Diseases, 2005