Anti-CD20 monoclonal antibody (rituximab) treatment for cryoglobulinemic vasculitis: where do we stand?

@article{Cacoub2007AntiCD20MA,
  title={Anti-CD20 monoclonal antibody (rituximab) treatment for cryoglobulinemic vasculitis: where do we stand?},
  author={Patrice Cacoub and Aur{\'e}lien Delluc and David Saadoun and Dan A. Landau and Damien S{\`e}ne},
  journal={Annals of the Rheumatic Diseases},
  year={2007},
  volume={67},
  pages={283 - 287},
  url={https://api.semanticscholar.org/CorpusID:7732479}
}
Rituximab therapy for patients with mixed cryoglobulinemia vasculitis, HCV-induced or essential, shows great efficacy on the main vasculation signs in the majority of reported patients, with a clinical response in 80–93% patients.
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153 Citations
Highly Influential Citations
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Background Citations
41
Methods Citations
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153 Citations

Rituximab in cryoglobulinaemic vasculitis, evidence for its effectivity: a case report and review of literature

A 72-year-old woman with mixed cryoglobulinaemia type 2, who has successfully been treated with rituximab infusions after failing on prednisone and azathioprine is described, who was reported four times and was related with the disease.

Clinical improvement induced by rituximab in two cases of type II mixed cryoglobulinaemia syndrome unresponsive to conventional treatments.

Clinical and biological data on two patients with type II mixed cryoglobulinaemia syndrome associated with chronic HCV infection unresponsive to conventional treatments, including therapeutic plasmapheresis, who were successfully treated with rituximab are reported on.

Restoration of peripheral immune homeostasis after rituximab in mixed cryoglobulinemia vasculitis.

Responsibility to B-cell depletion induced by rituximab effectively normalizes many of the disturbances in peripheral B- and T-lymphocyte homeostasis in patients with MC.

Current and future therapeutic strategies for treating mixed cryoglobulinemia

Rituximab is an effective and safe option for severe MC patients and new antiviral agents would allow eradication of HCV infection in up to 90% of cases and thus increase in the proportion ofHCV–MC remission.

Therapeutic Potential of Rituximab in Managing Hepatitis C-Associated Cryoglobulinemic Vasculitis: A Systematic Review

In conclusion, rituximab appeared to be effective and safe in managing hepatitis C-associated cryoglobulinemic vasculitis, either alone or with antiviral therapy.

Safety and efficacy of rituximab treatment for vasculitis in hepatitis B virus-associated type II cryoglobulinemia: a case report

This case highlights the benefit and the efficacy of rituximab in association with antiviral therapy in small vessel vasculitis related to hepatitis B virus-associated mixed cryoglobulinemia.

Rituximab plus belimumab in non-infectious refractory cryoglobulinemia vasculitis: A pilot study.

Rituximab may form a complex with IgMkappa mixed cryoglobulin and induce severe systemic reactions in patients with hepatitis C virus-induced vasculitis.

In HCV-associated MC vasculitis, rituximab may form a complex with RF-positive IgMkappa, leading to accelerated cryoprecipitation and to severe systemic reactions, which should be administered with caution in patients with high baseline levels of mixed cryoglobulin.

The Place of Immunotherapy in the Management of HCV-Induced Vasculitis: An Update

An updated overview on the place of immunotherapy, especially biologics, in the management of HCV-induced cryoglobulinaemic vasculitis is provided.

Long-term efficacy of rituximab in hepatitis C virus-associated cryoglobulinemia

The clinical and immunological responses induced by rituximab are sustained over long-term follow-up, and this case illustrates the drug efficacy for non-responder patients to antiviral therapy.
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24 References

Long-term effects of anti-CD20 monoclonal antibody treatment of cryoglobulinaemic glomerulonephritis.

Rituximab appears to be a safe and effective therapeutic option in symptomatic patients with HCV-associated MC glomerulonephritis and signs of systemic vasculitis.

Efficacy and safety of rituximab in type II mixed cryoglobulinemia.

Rituximab may represent a safe and effective alternative to standard immunosuppression in type II MC and is effective on skin vasculitis manifestations, subjective symptoms of peripheral neuropathy, low-grade B-cell lymphoma, arthralgias, and fever.

Rituximab treatment for glomerulonephritis in HCV-associated mixed cryoglobulinaemia: efficacy and safety in the absence of steroids.

Rituximab may provide effective and safe therapy in type II MC-related glomerulonephritis, possibly as first-line therapy, avoiding steroids and hazardous immunosuppressive treatment.

Rituximab Therapy for De Novo Mixed Cryoglobulinemia in Renal Transplant Patients

It is concluded that rituximab therapy is highly effective in cryoglobulin-related renal dysfunction in RT patients; however, due to chronic immunosuppression, this is at the expense of infectious complications.

Rituximab induces remission in refractory HCV associated cryoglobulinaemic vasculitis

Rituximab offers a new possibility for inducing remission in refractory HCV associated cryoglobulinaemic vasculitis and the lymphoproliferative disorder and may subsequently be eliminated with pegylated interferon α2b and ribavirin.

Remission of refractory hepatitis C-negative cryoglobulinaemic vasculitis after rituximab and infliximab.

A case of HCV-negative type II cryoglobulinaemia with severe multisystem disease, refractory to conventional agents but in whom rituximab led to falls in cryoglOBulin levels and partial disease control, and subsequent infliximab therapy led to full remission is reported.

Anti-CD20 monoclonal antibody (rituximab) treatment for hepatitis C-negative therapy-resistant essential mixed cryoglobulinemia with renal and cardiac failure.

Treatment with an anti-CD20 monoclonal antibody (rituximab) induced a persistent recovery of renal and cardiac function, disappearance of skin and joint lesions, and disappearance of cryoglobulins in a patient in remission and in a 24-month follow-up period.

Initial increase in the cryoglobulin level after rituximab therapy for type II cryoglobulinemia secondary to Waldenström macroglobulinemia does not indicate failure of response

A patient who presented with a large necrotic ulcerative lesion on the right ankle secondary to type II cryoglobulinemic vasculitis due to Waldenström macroglobulinemia that was resistant to multiple modalities of therapy is reported.

Serum sickness associated with rituximab in a patient with hepatitis C virus-related mixed cryoglobulinaemia.

A 60-yr-old woman who developed serum sickness after rituximab is reported, who developed a cushingoid aspect and severe osteoporosis and was still taking prednisone, with clinical improvement and normalization of transaminases.

Treatment of refractory antibody mediated autoimmune disorders with an anti-CD20 monoclonal antibody (rituximab)

Rituximab may be an important therapeutic agent for the treatment of patients refractory or intolerant to corticosteroid or cytotoxic treatment, or both.