https://doi.org/10.4081/reumatismo.2018.1011

The use of rituximab in idiopathic inflammatory myopathies: description of a monocentric cohort and review of the literature

Vol. 70 No. 2 (2018)
Submitted: 11 May 2017
Accepted: 5 December 2017
Published: 6 July 2018
Myositis, Refractory, Rituximab, Polymyositis, Dermatomyositis.
Abstract Views: 2358
PDF: 1228
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Authors

S. Barsotti
simone.barsotti.pisa@gmail.com
Rheumatology Unit, University of Pisa, Italy; Department of Medical Biotechnologies, University of Siena, Italy.
E. Cioffi
Rheumatology Unit, University of Pisa, Italy.
A. Tripoli
Rheumatology Unit, University of Pisa, Italy.
A. Tavoni
Clinical Immunoallergology, University of Pisa, Italy.
A. d’Ascanio
Rheumatology Unit, University of Pisa, Italy.
M. Mosca
Rheumatology Unit, University of Pisa, Italy.
R. Neri
Rheumatology Unit, University of Pisa, Italy.
Rituximab (RTX), a chimeric monoclonal antibody targeted against CD20, has been used to treat refractory inflammatory myopathies (IIM). The primary objective of this study was to retrospectively assess the efficacy of RTX in reducing disease activity in patients with IIM refractory to conventional therapy. Secondary aim was the evaluation of adverse events (AE) during the treatment period. We examined 26 patients with a diagnosis of IIM, referred to our Rheumatology Unit and treated with RTX for active refractory disease. Patients were treated with RTX 1000 mg i.v., twice, with a 2-week interval. RTX treatment was associated with a significant reduction of creatine kinase (p=0.001) after six months compared to the baseline, an improved muscular strength measured with MMT8 (p<0.001) and a reduction of the extramuscular activity of the disease measured with MYOACT (p<0.001). In particular, RTX improved DM skin rash, arthritis and pulmonary manifestations. Autoantibody positivity (in particular antisynthetase, anti- SRP and antiRo/SSA), and a disease duration <36 months at the moment of the treatment are associated with a better response rate. Treatment with RTX was also associated with a reduction of the mean daily dose of steroids needed to control disease activity (p=0.002). Our results have confirmed that RTX is efficacious in the treatment of refractory IIM. Ad hoc controlled trials are needed to better clarify the specific subset of patients who may better respond to the treatment and the optimal therapeutic schedule.

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S. Barsotti, Rheumatology Unit, University of Pisa, Italy; Department of Medical Biotechnologies, University of Siena
Rheumatology unit, university of Pisa, Italy

How to Cite

Barsotti, S., Cioffi, E., Tripoli, A., Tavoni, A., d’Ascanio, A., Mosca, M., & Neri, R. (2018). The use of rituximab in idiopathic inflammatory myopathies: description of a monocentric cohort and review of the literature. Reumatismo, 70(2), 78–84. https://doi.org/10.4081/reumatismo.2018.1011

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