Treatment of Primary Sjögren Syndrome With Rituximab

Devauchelle‐Pensec, Valérie; Mariette, Xavier; Jousse‐Joulin, Sandrine; Berthelot, Jean‐Marie; Perdriger, Aleth; Puéchal, Xavier; Guern, Véronique Le; Sibilia, Jean; Gottenberg, Jacques-Éric; Chiche, Laurent; Hachulla, É.; Hatron, P.Y.; Goëb, Vincent; Hayem, Gilles; Morel, Jacques; Zarnitsky, Charles; Dubost, Jean Jacques; Pers, Jacques Olivier; Nowak, Emmanuel; Saraux, Alain

doi:10.7326/m13-1085

Cited by 353 publications

(280 citation statements)

References 30 publications

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“…β2-microglobulin levels show a 'delayed' drop at 16 weeks after treatment [8,12], which was not seen at 6 or 12 weeks after rituximab treatment [8,11]. Serum immunoglobulin free light chains (FLCs) are also affected by rituximab and decrease significantly from week 5 up to week 48 after treatment (unpublished data), in line with findings in RA [19].…”

Section: Introductionsupporting

confidence: 72%

“…In other trials, including the TEARS trial, no effect on UWS was observed [6,8,11,15]. Although the mean baseline UWS in the TEARS trial was comparable to the study of Meijer et al, the standard deviation was twice as high, which may influence the power of their analysis.…”

Section: Effects On Exocrine Gland Function and Sicca Symptomsmentioning

confidence: 56%

“…Plasma cells are not directly depleted by rituximab, because expression of CD20 is downregulated when B cells differentiate towards plasma cells, but formation of new plasma cells may be impaired by B cell depletion therapy. Although initial studies in pSS showed improvement of both subjective and objective parameters [4][5][6][7], two large placebo-controlled trials [8,9] did not confirm all promising results of the earlier studies. Possible explanations for this discrepancy are heterogeneity in patient characteristics, primary end points and background medication use, which will all be discussed in this review.…”

Section: Introductionmentioning

confidence: 79%

“…Several open-label and randomized controlled trials have been performed to date, including two larger RCTs: the TEARS and TRACTISS trials [8,9]. In Tables 2 and 3, population characteristics and clinical outcomes of all prospective clinical trials reported in literature are summarized.…”

Section: Clinical Efficacy Of Rituximab In Primary Sjögren's Syndromementioning

confidence: 99%

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The value of rituximab treatment in primary Sjögren's syndrome

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Vissink

et al. 2017

Clinical Immunology

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Section: Introductionsupporting

confidence: 72%

Section: Effects On Exocrine Gland Function and Sicca Symptomsmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 79%

Section: Clinical Efficacy Of Rituximab In Primary Sjögren's Syndromementioning

confidence: 99%

See 2 more Smart Citations

The value of rituximab treatment in primary Sjögren's syndrome

Verstappen

Nimwegen

Vissink

et al. 2017

Clinical Immunology

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“…In rare cases, plasma exchange and rituximab may be of some value in improvement of symptoms for short duration without affecting the long-term outcome [12,13].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Sjogren syndrome with distal renal tubular acidosis and autoimmune hypothyroidism: an uncommon association

2015

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A 14-year-old female came with the history of sudden onset weakness; during work up, she was found to have hyperchloremic metabolic acidosis with normal anion gap and normal renal function suggesting the possibility of renal tubular acidosis (RTA). On further evaluation of RTA, she had positive antinuclear antibody, anti-Ro, and anti-La antibodies. On nuclear scan of salivary glands, her left parotid gland was nonfunctional. Her parotid biopsy revealed dilated interlobular ducts engulfed by lymphoid cells. She also had autoimmune hypothyroidism as suggested by raised TSH and positive anti-TPO antibodies. At admission, her serum potassium levels were low and she was treated with intravenous potassium chloride. After she recovered from acute hypokalemic paralysis, she was started on oral potassium citrate along with phosphate supplements, hydroxychloroquine, oral prednisolone and thyroxine supplements. Over the next 6 months, she has significant reduction in the dosage of potassium, bicarbonate and phosphate and gained 3 kg of weight and 3.5 cm of height. As primary Sjogren syndrome itself is rare in pediatric population and its association with renal tubular acidosis is even rarer, we suggest considering Sjogren syndrome as a differential diagnosis during the RTA work-up is worth trying.

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