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B Cell-Targeted Therapy in Diseases Other Than Rheumatoid Arthritis
R. JOHN LOONEY
ABSTRACT.
There are now numerous case reports and small series using rituximab in autoimmune diseases. While these data must be interpreted with caution, they suggest that rituximab (RTX) may be a promising addition to the therapeutic armamentarium. In patients with refractory chronic idiopathic thrombocytopenic purpura, treatment with RTX was effective in inducing complete responses in a significant proportion of patients, and these responses were usually durable. RTX has also been shown to be effective and well tolerated in children with refractory autoimmune hemolytic anemia. In patients with IgM antibody-associated polyneuropathy, RTX improved muscle strength, and repeated treatments over 2 years were well tolerated. In several case series of patients with systemic lupus erythematosus, depletion of B cells during RTX therapy was associated with improvement in global disease activity. Based on these reports, further controlled studies are warranted to optimize RTX as monotherapy and to develop combination therapies in patients with refractory autoimmune diseases. (J Rheumatol 2005;32 Suppl 73:25-8)
Key Indexing Terms:
RITUXIMAB
IDIOPATHIC THROMBOCYTOPENIC PURPURA
AUTOIMMUNE HEMOLYTIC ANEMIA
POLYNEUROPATHIES
DERMATOMYOSITIS
SYSTEMIC LUPUS ERYTHEMATOSUS
From the Allergy/Immunology and Rheumatology Unit, University of Rochester Medical Center, Rochester, New York, USA.
This educational activity is sponsored by the University of Texas Southwestern Medical Center at Dallas, which is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians, through an unrestricted educational grant from Genentech, Inc. and Biogen Idec Inc.
R.J. Looney, MD, Associate Professor of Medicine.
Address reprint requests to Dr. R.J. Looney, Allergy/Immunology and Rheumatology Unit, University of Rochester Medical Center,
601 Elmwood Avenue, Box 695, Rochester, NY 14642. E-mail: john_looney@urmc.rochester.edu
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