Primary biliary cirrhosis in a rheumatoid arthritis patient treated with rituximab, a case-based review

Polido-Pereira, Joaquim; Rodrigues, Ana Maria; Canhão, Helena; Saraiva, Fernando; Silva, José Alberto Pereira da; Fonseca, João Eurico

doi:10.1007/s10067-011-1879-y

Cited by 15 publications

(6 citation statements)

References 30 publications

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“…Respecto al curso de la CBP ante el uso de rituximab para indicación de AR encontramos 4 casos 7,8,12 . Sargin y cols.…”

Section: Discussionunclassified

“…Debido a que la paciente seguía con alta actividad de la AR le indicaron abatacept. La CBP continuó quiescente 7 . La justificación de la utilización de terapias depletoras anti-CD20 no está muy clara, pero los autores describen la participación de las células B en la patogenia de la CBP e incluso reportes de pacientes con CBP con respuesta subóptima al ácido ursodesoxicólico, que tratados con rituximab mejoraron los parámetros bioquímicos hepáticos 12 .…”

Section: Discussionunclassified

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Rheumatoid arthritis associated with primary biliary cholangitis under treatment with biological drugs

Jones

Bertone

Savio

et al. 2019

Rev. Argent. Reumatol.

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The therapeutic approach of patients with two or more autoimmune diseases is quite a challenge, especially when the treatment of one of them, can precipitate the progression of the other. Even though the association of rheumatoid arthritis (RA) and primary biliary cholangitis (PBC) is rare; when both coexist, the use of methotrexate and other hepatotoxic drugs should be used with caution. With a most widespread indication of biologic disease- modifying antirheumatic drugs (bDMARDs) some reports of patients with RA and PBC treated with etanercept, infliximab, rituximab, tocilizumab and abatacept have been published. We report a case series that includes 4 patients with RA and PBC treated with bDMARDs. This is the first report to describe two cases in which golimumab was used to control RA and the second to report patients who received adalimumab and abatacept. Three cases of patients treated with rituximab have been published to date. None of the patients of our report suffered a progression of their PBC; matter in fact, two of them showed an improvement in their biochemical parameters. PBC symptoms did not get worse in any of the patients. On the contrary, laboratory parameters improved in two of the four patients.

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“…Respecto al curso de la CBP ante el uso de rituximab para indicación de AR encontramos 4 casos 7,8,12 . Sargin y cols.…”

Section: Discussionunclassified

Rheumatoid arthritis associated with primary biliary cholangitis under treatment with biological drugs

Jones

Bertone

Savio

et al. 2019

Rev. Argent. Reumatol.

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“…Recently, the anti-CD20 monoclonal antibody rituximab was suggested as a treatment option for PBC [8, 11]. Biological and immunological improvements, such as of biliary enzyme, serum IgM and serum AMA titer, have been reported [8, 11]. However, histological improvement has not been reported previously.…”

Section: Discussionmentioning

confidence: 99%

A Case of Primary Biliary Cirrhosis That Progressed Rapidly after Treatment Involving Rituximab

Tajiri

Tsuneyama

Miyazono

et al. 2013

Case Rep Gastroenterol

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Primary biliary cirrhosis (PBC) is a progressive liver disease for which limited therapies are recommended. Rituximab, an anti-CD20 monoclonal antibody, is expected to be a useful therapeutic regimen for PBC. Previous studies indicated biochemical and immunological improvement in PBC after rituximab treatment. Although rituximab shows therapeutic potential for PBC, few cases have been reported and histological improvement and long-term outcome remain uncertain. Here, we report a case of PBC in a 66-year-old Japanese female patient who presented with a gastric lymphoma and who had been treated with a regimen containing rituximab for incidental malignant lymphoma. She showed biochemical and immunological improvements, and liver histology before and after rituximab treatment confirmed a decrease in liver inflammation. However, she developed liver cirrhosis a short time after rituximab treatment without biochemical or immunological worsening. Rituximab treatment for PBC might be considered and careful observation is required after treatment.

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“…The results of this study showed that rituximab was as safe and well-tolerated in patients with PBC as in patients with other indications, suggesting that rituximab has a potential therapeutic effect in this subgroup of patients without optimal responses to UDCA [5]. Another case reported on a 50-year-old patient with RA and PBC who was treated with rituximab and showed clinical and laboratory improvement in the first six months of treatment [12]. In our patient, we used a small amount of MTX (7.5mg/week) combined with two doses of 1000mg of rituximab, two weeks apart.…”

Section: Discussionmentioning

confidence: 99%

A rare association of rheumatoid arthritis and primary biliary cirrhosis treated with rituximab: a case report

et al. 2013

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IntroductionPrimary biliary cirrhosis is an autoimmune disease that tends to progress to fibrosis and cirrhosis with hepatic failure. Primary biliary cirrhosis is often associated with other non- hepatic autoimmune diseases. An association with rheumatoid arthritis has been suggested to coexist in 1.8% to 5.6% of patients with primary biliary cirrhosis, but data supporting this association are scarce. The etiologic and pathogenetic mechanisms are not yet fully understood and several factors have been implicated. The therapeutic management must consider the two pathologies.Case presentationWe describe the case of a 60-year-old Moroccan woman with severe erosive rheumatoid arthritis and primary biliary cirrhosis treated with rituximab. During treatment, we observed a good clinical and biological response of her rheumatoid arthritis but persistent abnormal liver function tests.ConclusionB cells seem to play a major role in the pathogenesis of both rheumatoid arthritis and primary biliary cirrhosis. Additional studies are necessary to better determine the therapeutic role of rituximab in both diseases.

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Primary biliary cirrhosis in a rheumatoid arthritis patient treated with rituximab, a case-based review

Abstract: Primary biliary cirrhosis

Cited by 15 publications

References 30 publications

Rheumatoid arthritis associated with primary biliary cholangitis under treatment with biological drugs

Rheumatoid arthritis associated with primary biliary cholangitis under treatment with biological drugs

A Case of Primary Biliary Cirrhosis That Progressed Rapidly after Treatment Involving Rituximab

A rare association of rheumatoid arthritis and primary biliary cirrhosis treated with rituximab: a case report

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