Rituximab therapy for multisystem autoimmune diseases in pediatric patients

Binstadt, Bryce A; Caldas, Álvaro Manuel; Turvey, Stuart E.; Weinstein, Howard J.; Jackson, Jean M.; Fuhlbrigge, Robert C.; Sundel, Robert P.

doi:10.1067/s0022-3476(03)00382-2

Cited by 49 publications

(30 citation statements)

References 27 publications

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“…22 Its efficiency in childhood-onset SLE has been reported only in 1 child with hemolytic anemia, 18,23 in another child with autoimmune thrombocytopenic purpura, 24 and very recently in 7 patients with active SLE resistant to standard immunosuppressive agents 25 ; however, it was unsuccessful in a 14-year-old teenager with WHO class IV glomerulonephritis. 26 Therefore, we present a series of rituximab therapy for severe childhood-onset SLE.…”

Section: Discussionmentioning

confidence: 98%

Rituximab therapy for childhood-onset systemic lupus erythematosus

Willems

Haddad

Niaudet

et al. 2006

The Journal of Pediatrics

125

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Section: Discussionmentioning

confidence: 98%

Rituximab therapy for childhood-onset systemic lupus erythematosus

Willems

Haddad

Niaudet

et al. 2006

The Journal of Pediatrics

125

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“…Rituximab depletes B cells from the circulation and from [16,17]. It has been used with increasing frequency in both systemic autoimmune diseases and neurological ones, such as myasthenia gravis, neuromyelitis optica, stiff man syndrome or opsoclonus-myoclonus syndrome in both adults and children [11,[18][19][20][21][22]. Yet, the possible severe infectious and allergic adverse events reported with the use of the rituximab in pediatric cases and the lack of prospective studies in autoimmune neurological diseases should be pondered before its use [11].…”

Section: Discussionmentioning

confidence: 98%

Treatment and outcome of children and adolescents with N-methyl-d-aspartate receptor encephalitis

et al. 2015

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The objective of this study is to describe the treatment and outcome of children and adolescents with N-methyl-D-aspartate receptor (NMDA-R) encephalitis. A retrospective study of children and adolescents with NMDA-R encephalitis was performed by the French Paraneoplastic Neurological Syndrome Reference Center between January 1, 2007 and December 31, 2012. The modified Rankin scale (mRS) was used to assess outcome. Thirty-six children and adolescents with NMDA-R encephalitis were studied. All of the patients received first-line immunotherapy (corticosteroids, intravenous immunoglobulins or plasma exchange), and 81% received second-line immunotherapy (rituximab or cyclophosphamide). Median time between first-line and second-line treatment was 26 days. During the first 24 months, 30 of 36 patients (83%) achieved a good outcome (mRS ≤ 2) and 20 of 36 patients (56%) achieved complete recovery (mRS = 0). Median time to good outcome and to complete recovery was 6 and 24 months, respectively. Three patients (8%) relapsed, one patient died. In multivariate analysis, age >12 years was a predictor of good outcome and initial mRS ≤ 3 was a predictor of complete recovery. Despite a higher rate of patients who received second-line immunotherapy, the outcome of the patients in the present series was very similar to the outcome reported in previous series. The present study highlights the need for clinical trials to determine the optimal treatment of NMDA-R encephalitis.

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“…[4][5][6] There are rather limited studies in children. 4,5,7,8 The exact mechanism of rituximab in chronic ITP is not exact clear. Rituximab decreases the number of Bcells, which expresses CD-20 surface antigen.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 In order to assess the outcomes of rituximab treatment, the patients must be followed during and after the treatment of rituximab for at least 23 weeks, until 12 months. 8 Our patients have been followed up at least 12 mo and at most 42 mo.…”

Section: Discussionmentioning

confidence: 99%

Treatment of chronic immune thrombocytopenic purpura with rituximab in children

et al. 2009

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CR was found in 20% of our patients, PR in 10% and MR in 30% with rituximab. On this treatment, while some series had good outcomes with this treatment (72%-100%, remission ratios), but many series, such as ours, had a poor response rate contrast to many reported case series in the literature. This condition may be associated with the age of our most patients who were young at the time of commenced rituximab. However, we believe that more studies are required to elucidate the reasons for different results in different case series reported in literature.

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Rituximab therapy for multisystem autoimmune diseases in pediatric patients

Cited by 49 publications

References 27 publications

Rituximab therapy for childhood-onset systemic lupus erythematosus

Rituximab therapy for childhood-onset systemic lupus erythematosus

Treatment and outcome of children and adolescents with N-methyl-d-aspartate receptor encephalitis

Treatment of chronic immune thrombocytopenic purpura with rituximab in children

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