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Patients with SLE, SS and autoimmune thrombocytopenia may benefit from Rituxan
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Patients with systemic lupus erythematosus or Sjögren's syndrome who also had autoimmune thrombocytopenia improved after taking Rituxan, according to recently published research.
15 patients systemic lupus erythematosus (SLE)seven patients Sjögren's syndrome (SS) one of the patients had both SLE and SS. Twenty patients were women, the median age was 37.05 years and the disease duration at entry was 6.95 years. Duration of autoimmune thrombocytopenia (AITP) was a median of 5.46 years. Comorbidities included nephritis (n = 3), lupus encephalopathy (n = 1), interstitial lung disease (n = 1), hemorrhagic pulmonary alveolitis (n = 1), pulmonary hypertension (n = 32) and Evans syndrome (n = 1) and patients continued immunosuppressive, antimalarial or other treatments.
Patients received either 200 mg every week or 500 mg every 2 weeks of Rituxan (rituximab, Genentech) infusions and were evaluated for platelet counts as an indicator of improvement of AITP at baseline and 0.5, 1, 3, 6 and 12 months. Other serological tests included extractable nuclear antibodies and immunoglobulins.
Eleven patients had complete response defined by a platelet count greater than 100 x 109/mL or by maintaining a platelet count greater than 100 x 109/mL. Six patients had a partial response as defined by a platelet count of 30 x 109/mL to 100 x 109/mL, or more than twice the number of platelets prior to treatment. Four patients achieved a complete response and seven achieved a response at week 2.
Six patients experienced a relapse of AITP after the first treatment with rituximab at a median of 5.17 months and were treated with methylprednisolone pulse therapy for 5 to 7 days. Eleven patients who met complete or partial response achieved and maintained complete remission after a median follow-up time of 10.27 months.
No severe allergic reactions or adverse events were observed in 71.42% of patients. Two patients died from pneumonia and refractory AITP. Adverse events including infusion site reaction were cited as cause for discontinuation of treatment by five patients. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.
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