Intraorbital injection of Rituximab in idiopathic orbital inflammatory syndrome: case reports

Savino, Gustavo; Battendieri, Remo; Siniscalco, Andrea; Mandarà, Erika; Mulè, Antonino; Petrone, Gianluigi; Traina, Salvatore; Riso, Monica

doi:10.1007/s00296-014-3054-7

Cited by 24 publications

(9 citation statements)

References 34 publications

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“…One of our patients (patient 4) treated with rituximab did not show any improvement of scleral inflammation. She was initially diagnosed with an orbital inflammatory disease and was therefore prescribed rituximab based on recent reports of its efficacy in this condition [16,17]. She is now under investigation to start an anti-TNF-α monoclonal antibody.…”

Section: Mediators Of Inflammationmentioning

confidence: 99%

New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy

Fabiani

Sota

Maza

et al. 2020

Mediators of Inflammation

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Objective. To assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the efficacy of several biologic agents (rituximab, anakinra, tocilizumab, and abatacept) and the small molecule tofacitinib in the treatment of scleritis through assessment of scleral inflammation and relapses, as well as treatment impact on best-corrected visual acuity (BCVA) and safety profile. Results. Fourteen patients (19 eyes) were enrolled in the study. Scleritis inflammatory grading significantly improved from baseline to 3 months (p=0.002) and from baseline to the last follow-up visit (p=0.002). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p=0.007). No differences regarding BCVA were observed (p=0.67). Regarding adverse events, only one patient developed pneumonia and septic shock under rituximab treatment. Conclusions. Our results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses.

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Section: Mediators Of Inflammationmentioning

confidence: 99%

New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy

Fabiani

Sota

Maza

et al. 2020

Mediators of Inflammation

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“…Of these patients, two patients required 2 months of RTX and one required 1 month of RTX treatment at 17.6 months' follow-up. [ 60 ]…”

Section: Lymphocyte Inhibitorsmentioning

confidence: 99%

Idiopathic orbital inflammation: Review of literature and new advances

Yeşiltaş

Gündüz

2018

Middle East Afr J Ophthalmol

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Idiopathic orbital inflammation (IOI) is a benign inflammatory condition usually confined to the orbit but extraorbital extension can also occur. IOI has been classified into categories including anterior, diffuse, posterior or apical, myositis, and dacryoadenitis. Other rare types of IOI include periscleritis, perineuritis, and focal mass. Diagnosis is based on careful history, clinical findings, computed tomography, and magnetic resonance imaging findings. An orbital biopsy is usually done for accessible orbital lesions such as dacryoadenitis. For other types such as myositis and apical IOI where surgery is difficult or dangerous, orbital biopsy is not initially considered. The mainstay of therapy consists of systemic corticosteroids, but other options including external beam radiotherapy, antimetabolites, alkylating agents, T-cell/calcineurin inhibitors, lymphocyte inhibitors, tumor necrosis factor-α inhibitors, and surgical debulking have also been used.

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“…Použití rituximabu pro léčbu IgG4 asociované nemoci je věnováno hodně publikací a z popsaných zkušeností vyplývá, že tato léčba je celosvětově považována za léčbu volby při jakékoliv orgánové lokalizaci s velmi dobrou účinností již od roku 2012. Dobré účinky jsou popsány i po lokální aplikaci při postižení orbity či mening [62][63][64][65][66][67][68][69][70][71][72][73][74]. Recidivy této nemoci se uvádějí až ve 40 % [62][63][64][65][66][67][68][69][70][71][72][73][74].…”

Section: Terapieunclassified

Remission of the disease associated/related with immunoglobulin IgG4 accompanied by multiple lymphadenopathy after treatment with rituximab and dexamethasone: a case report

Adam¹,

Chovancová²,

Nová³

et al. 2018

Vnitř Lék

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SouhrnS imunoglobulinem IgG4 asociované onemocnění (the disease associated/related with immunoglobulin IgG4) je vzácná jednotka s velmi různorodými příznaky. Popisujeme průběh a léčbu pacientky, u níž se tato nemoc projevila vícečetnou lymfadenopatií a infiltráty v oblasti retroperitonea a pánve a známkami chronické sklerotizující pankreatitidy. Klinicky se nemoc manifestovala značným úbytkem hmotnosti, ale i ztrátou vnímání chuti a čichu. Diagnóza byla stanovena na základě vysokého počtu IgG4 exprimujících plazmatických buněk v odebrané tkáni a zvýšené koncentrace imunoglobulinů typu IgG a hlavně podtřídy IG4. Pro léčbu byl použit rituximab v dávce 475 mg/m 2 . První 4 dávky rituximabu byly aplikovány ve 14denních intervalech vždy s jednorázovým podáním dexametazonu v dávce 40 mg. Po 4 aplikacích rituximabu a dexametazonu došlo dle FDG-PET/CT jen k parciální remisi nemoci. U pacientky se opět obnovil čich i chuť. V dalších 4 cyklech byl podáván rituximab den 1 v 28denním cyklu. A 1. a 15. den tohoto cyklu byl podáván dexametazonu 40 mg a cyklofosfamid 600 mg v nitrožilní infuzi. Po ukončení 8 cyklů léčby založené na rituximabu a dexametazonu a v druhé polovině léčby doplněné o cyklofosfamid prokázalo kontrolní FDG-PET/CT kompletní remisi nemoci. Před zahájením léčby byla koncentrace podtřídy imunoglobulinu IgG4 51,0 g/l, po ukončení výše popsané léčby poklesla na 3,5 g/l. Pacientka léčbu snášela bez jakýchkoliv nežádoucích účinků. Rituximab, dexametazon a cyklofosfamid indukoval kompletní remisi této nemoci. Klíčová slova: IgG4 asociované onemocnění (IgG4-associated/releated disease) -rituximab Remission of the disease associated/related with immunoglobulin IgG4 accompanied by multiple lymphadenopathy after treatment with rituximab and dexamethasone: a case report SummaryA disease associated with immunoglobulin IgG4 is a rare unit with very variable symptoms. We describe the course and treatment of the disease in a patient who presented with multiple lymphadenopathy and infiltrates in the area of the retroperitoneum and pelvis and signs of chronic sclerosing pancreatitis. The disease was clinically manifested by a significant loss of weight, but also by a loss of perception of taste and smell. The diagnosis was made based on a high amount of IgG4 expressing plasma cells in the sampled tissue and an increased concentration of immunoglobulins of type IgG and mainly subclass IG4. Rituximab in 475 mg/m2 dose was used in the treatment, the initial four doses of rituximab were administered at 14-day intervals, always with a one-off administration of a 40 mg dose of dexamethasone. According to FDG-PET/CT, only partial remission of the disease was reached after 4 applications of rituximab and dexamethasone. The patient recovered its sense of smell and taste. In another 4 cycles Interní hematologická a onkologická klinika LF MU a FN v Brně, pracoviště Bohunice www.fnbrno.cz

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Intraorbital injection of Rituximab in idiopathic orbital inflammatory syndrome: case reports

Cited by 24 publications

References 34 publications

New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy

New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy

Idiopathic orbital inflammation: Review of literature and new advances

Remission of the disease associated/related with immunoglobulin IgG4 accompanied by multiple lymphadenopathy after treatment with rituximab and dexamethasone: a case report

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