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- Title
Long-Term Effects of Rituximab Added to Cyclophosphamide in Refractory Patients with Vasculitis.
- Authors
Roccatello, Dario; Sciascia, Savino; Rossi, Daniela; Alpa, Mirella; Naretto, Carla; Russo, Alessandra; Menegatti, Elisa; Baldovino, Simone
- Abstract
Background: Current therapies have changed systemic vasculitis from a disease with a high rate of mortality to a chronic curable condition. A limited percentage of patients either remains refractory to conventional treatment or experiences dose-limiting side effects. Methods: 11 patients (4 affected by idiopathic systemic microscopic polyangiitis, 5 by Wegener's granulomatosis, and 2 by Churg-Strauss syndrome) intolerant or refractory to conventional therapies including cyclophosphamide were enrolled. All patients received rituximab as a rescue therapy and were followed for 30-54 months. Following rituximab administration, immunosuppressive drugs were rapidly tapered and no immunosuppressive maintenance therapy was given. Results: Significant decreases in levels of serum creatinine, proteinuria, erythrocyte sedimentation rate, C-reactive protein, and ANCA titers were observed during the follow-up (at least 30 months after rituximab administration). Arthralgia and weakness rapidly disappeared in all patients. Out of 7 patients, 5 reported a decrease in the degree of paresthesia and in the electrophysiologic parameters. Six months after rituximab administration the mean dose of prednisone was 5.5 mg/day. Conclusion: In this sample of patients with systemic vasculitis who were refractory or intolerant to more conventional treatment, rituximab proved to be safe and effective in a long-term follow-up, and showed steroid- and immunosuppressive-sparing effects allowing the persistence of long-lasting remissions without maintenance therapy. Copyright © 2011 S. Karger AG, Basel
- Publication
American Journal of Nephrology, 2011, Vol 34, Issue 2, p175
- ISSN
0250-8095
- Publication type
Article
- DOI
10.1159/000329535