Abstract | INTRODUCTION: METHODS: We report a single-center cohort of patients with eosinophilic granulomatosis with polyangiitis. Of these patients, nine (six ANCA-positive, three ANCA-negative) had been treated with RTX for relapsing or refractory disease on standard immunosuppressive treatment. In a retrospective analysis, data on treatment response, frequency of relapses, adverse events, and peripheral B-cell reconstitution were evaluated. Furthermore, serum immunoglobulin concentrations, ANCA status, and peripheral B cell subpopulations were assessed after RTX treatment. RESULTS: All patients had high disease activity before RTX treatment. At presentation 3 months after RTX therapy, all ANCA-positive and ANCA-negative patients had responded to RTX, with one patient being in complete remission, and eight patients being in partial remission. After a mean follow-up of 9 months, C-reactive protein concentrations had normalized, eosinophils had significantly decreased, and prednisone had been tapered in all patients. In all patients, RTX therapy was combined with a standard immunosuppressive therapy. Within the 9-month observation period, no relapse was recorded. Three patients were preemptively retreated with RTX, and during the median follow-up time of 3 years, no relapse occurred in these patients. During the follow-up of 13 patient-years, five minor but no major infections were recorded. CONCLUSIONS: In our analysis on nine patients with EGPA resistant to standard therapy, rituximab proved to be an efficient and safe treatment for ANCA-positive and ANCA-negative patients. Preemptive retreatment with RTX, combined with standard maintenance immunosuppressants, resulted in a sustained treatment response. Prospective, randomized trials evaluating the use of RTX in EGPA are warranted.
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Authors | Jens Thiel, Fabian Hässler, Ulrich Salzer, Reinhard E Voll, Nils Venhoff |
Journal | Arthritis research & therapy
(Arthritis Res Ther)
Vol. 15
Issue 5
Pg. R133
(Sep 24 2013)
ISSN: 1478-6362 [Electronic] England |
PMID | 24286362
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Antineutrophil Cytoplasmic
- Antibodies, Monoclonal, Murine-Derived
- Antirheumatic Agents
- Immunosuppressive Agents
- Immunoglobulin E
- Rituximab
- C-Reactive Protein
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Topics |
- Adult
- Antibodies, Antineutrophil Cytoplasmic
(blood)
- Antibodies, Monoclonal, Murine-Derived
(therapeutic use)
- Antirheumatic Agents
(therapeutic use)
- B-Lymphocyte Subsets
(drug effects, metabolism)
- C-Reactive Protein
(metabolism)
- Churg-Strauss Syndrome
(blood, drug therapy, pathology)
- Drug Resistance
- Female
- Follow-Up Studies
- Humans
- Immunoglobulin E
(blood)
- Immunosuppressive Agents
(therapeutic use)
- Lymphocyte Count
- Male
- Middle Aged
- Recurrence
- Retrospective Studies
- Rituximab
- Time Factors
- Treatment Outcome
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