Management of Therapy-Resistant Systemic Lupus Erythematosus With Rituximab: Report of a Case and Review of the Literature

Bergh, Barbara Van den; Selleslag, Dominik; Boelaert, Johan R.; Matthys, E; Schurgers, M.; Vandecasteele, Stefaan; Vriese, An S. De

doi:10.1179/acb.2005.019

Cited by 10 publications

(4 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our search yielded 24 articles including 18 case reports, one retrospective cohort study and five prospective studies documenting 65 patients. 18,32–55 Fifty-five patients received RTX because of immune thrombocytopenia and in 10 patients TTP was diagnosed. The results are summarized in Table 2.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Anti B-cell therapy against refractory thrombocytopenia in SLE and MCTD patients: long-term follow-up and review of the literature

Jovancevic

Lindholm

Pullerits

2013

Lupus

View full text Add to dashboard Cite

The median disease duration before RTX treatment was nine years (range 0.2-27) and the median post-treatment follow-up time was 28 months (range 3 to 92). Ten patients (63%) were treated repeatedly with RTX during the follow-up period. Complete depletion of B cells was achieved in 94% of cases one month after RTX treatment. A significant increase (p = 0.0001) of platelet counts was seen already after one month (median 58 × 10(9)/ml vs 110 × 10(9)/ml) whereas within three months platelet counts normalized in 10 patients (median 223 × 10(9)/ml). Three patients did not respond to RTX treatment (median platelet count 69 × 10(9)/ml). High titers of anti-platelet antibodies were detected in seven patients before RTX treatment, and the autoantibody titers decreased significantly (p < 0.03) after RTX treatment in six of these patients who also achieved complete remission. A review of the literature revealed 24 articles including 18 case reports, one retrospective cohort study and five prospective studies documenting the outcomes of 65 RTX-treated patients with SLE- or MCTD-related thrombocytopenia with an overall treatment response rate of 80%. In conclusion, these findings indicate that RTX is an additional potent therapeutic treatment option for SLE patients with AITP refractory to conventional immunosuppressive treatment whereas best response may be expected in patients with high titers of anti-platelet antibodies at baseline.

show abstract

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Anti B-cell therapy against refractory thrombocytopenia in SLE and MCTD patients: long-term follow-up and review of the literature

Jovancevic

Lindholm

Pullerits

2013

Lupus

View full text Add to dashboard Cite

show abstract

“…SLE is an autoimmune disease characterized by immune dysregulation resulting in overproduction of autoantibodies (16). Although the exact cause of SLE remains unknown, recent studies, including a demonstration of the effectiveness of therapeutic B cell depletion, strongly implicate B cells as central players in the pathogenesis of this disease (17)(18)(19)(20). We therefore, hypothesized that 1,25(OH) 2 D 3 may be important in maintaining B cell homeostasis and that deficiency of 1,25(OH) 2 D 3 might contribute to B cell hyperactivity in SLE.…”

mentioning

confidence: 99%

Modulatory Effects of 1,25-Dihydroxyvitamin D3 on Human B Cell Differentiation

Chen

Sims

Chen

et al. 2007

The Journal of Immunology

994

766

View full text Add to dashboard Cite

1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) can modulate immune responses, but whether it directly affects B cell function is unknown. Patients with systemic lupus erythematosus, especially those with antinuclear Abs and increased disease activity, had decreased 1,25(OH)2D3 levels, suggesting that vitamin D might play a role in regulating autoantibody production. To address this, we examined the effects of 1,25(OH)2D3 on B cell responses and found that it inhibited the ongoing proliferation of activated B cells and induced their apoptosis, whereas initial cell division was unimpeded. The generation of plasma cells and postswitch memory B cells was significantly inhibited by 1,25(OH)2D3, although the up-regulation of genetic programs involved in B cell differentiation was only modestly affected. B cells expressed mRNAs for proteins involved in vitamin D activity, including 1α-hydroxylase, 24-hydroxylase, and the vitamin D receptor, each of which was regulated by 1,25(OH)2D3 and/or activation. Importantly, 1,25(OH)2D3 up-regulated the expression of p27, but not of p18 and p21, which may be important in regulating the proliferation of activated B cells and their subsequent differentiation. These results indicate that 1,25(OH)2D3 may play an important role in the maintenance of B cell homeostasis and that the correction of vitamin D deficiency may be useful in the treatment of B cell-mediated autoimmune disorders.

show abstract

“…Debido a que no existe un patrón inmunológico claramente definido y prevalente para establecer el diagnóstico de la enfermedad, los criterios de clasificación siguen siendo la piedra anguar para establecer el diagnóstico temprano 6,7 . Las dificultades inherentes a su aplicación traen como consecuencia un inicio tardío en su manejo terapéutico, a pesar de que en los últimos años se han empezado a utilizar distintos tratamientos para el control de la enfermedad como el micofenolato de mofetilo (MMF), las terapias anti-TNF alfa (adalimumab y etanercept) y la terapia Anti CD20 (Rituximab) 8,9,10 .…”

Section: Acta Reumatológica Issn 2386-6861unclassified

Aparición de psoriasis post infusión de rituximab en un paciente con polimiositis/dermatomiositis

Gutiérrez-González¹

2015

acta reuma

View full text Add to dashboard Cite

Management of Therapy-Resistant Systemic Lupus Erythematosus With Rituximab: Report of a Case and Review of the Literature

Cited by 10 publications

References 19 publications

Anti B-cell therapy against refractory thrombocytopenia in SLE and MCTD patients: long-term follow-up and review of the literature

Anti B-cell therapy against refractory thrombocytopenia in SLE and MCTD patients: long-term follow-up and review of the literature

Modulatory Effects of 1,25-Dihydroxyvitamin D3 on Human B Cell Differentiation

Aparición de psoriasis post infusión de rituximab en un paciente con polimiositis/dermatomiositis

Contact Info

Product

Resources

About