Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry
Identifieur interne : 002324 ( Istex/Corpus ); précédent : 002323; suivant : 002325Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry
Auteurs : Jacques-Eric Gottenberg ; Gael Cinquetti ; Claire Larroche ; Bernard Combe ; Eric Hachulla ; Olivier Meyer ; Edouard Pertuiset ; Guy Kaplanski ; Laurent Chiche ; Jean-Marie Berthelot ; Bruno Gombert ; Philippe Goupille ; Christian Marcelli ; Séverine Feuillet ; Jean Leone ; Jean Sibilia ; Charles Zarnitsky ; Philippe Carli ; Stephanie Rist ; Philippe Gaudin ; Carine Salliot ; Muriel Piperno ; Adeline Deplas ; Maxime Breban ; Thierry Lequerre ; Pascal Richette ; Charles Ghiringhelli ; Mohamed Hamidou ; Philippe Ravaud ; Xavier MarietteSource :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2013-06.
English descriptors
- Teeft :
- Autoimmune, Autoimmune diseases, Autoimmune pancreatitis, Club rhumatismes, Common practice, Corticosteroid, Data collection, Essdai, French society, Immunosuppressant, Infusion, Lymphoma, Median, Present study, Primary syndrome, Registry, Renal involvement, Rheum, Rheumatoid arthritis, Rheumatology, Rhumatologie, Rituximab, Rituximab regimen, Rituximab registry, Second cycle, Second infusion, Serious infections, Serum disease, Syndrome, Systemic, Systemic complications, Systemic involvement, Systemic lupus erythematosus, Vasculitis.
Abstract
Objectives To evaluate the efficacy and safety of rituximab in patients with primary Sjögren's syndrome (pSS). Methods The AutoImmune and Rituximab registry has included 86 patients with pSS treated with rituximab, prospectivey followed up every 6 months for 5 years. Results Seventy-eight patients with pSS (11 men, 67 women), who already had at least one follow-up visit, were analysed. Median age was 59.8 years (29–83), median duration of disease was 11.9 years (3–32). Indications for treatment were systemic involvement for 74 patients and only severe glandular involvement in four patients. The median European Sjögren's Syndrome disease activity index (ESSDAI) was 11 (2–31). 17 patients were concomitantly treated with another immunosuppressant agent. Median follow-up was 34.9 months (6–81.4) (226 patient-years). Overall efficacy according to the treating physician was observed in 47 patients (60%) after the first cycle of rituximab. Median ESSDAI decreased from 11 (2–31) to 7.5 (0–26) (p<0.0001). Median dosage of corticosteroid decreased from 17.6 mg/day (3–60) to 10.8 mg/day (p=0.1). Forty-one patients were retreated with rituximab. Four infusion reactions and one delayed serum sickness-like disease resulted in rituximab discontinuation. Three serious infections (1.3/100 patient-years) and two cancer-related deaths occurred. Conclusions In common practice, the use of rituximab in pSS is mostly restricted to patients with systemic involvement. This prospective study shows good efficacy and tolerance of rituximab in patients with pSS and systemic involvement.
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DOI: 10.1136/annrheumdis-2012-202293
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title><author><name sortKey="Gottenberg, Jacques Eric" sort="Gottenberg, Jacques Eric" uniqKey="Gottenberg J" first="Jacques-Eric" last="Gottenberg">Jacques-Eric Gottenberg</name><affiliation><mods:affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Cinquetti, Gael" sort="Cinquetti, Gael" uniqKey="Cinquetti G" first="Gael" last="Cinquetti">Gael Cinquetti</name><affiliation><mods:affiliation>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz, France</mods:affiliation></affiliation></author><author><name sortKey="Larroche, Claire" sort="Larroche, Claire" uniqKey="Larroche C" first="Claire" last="Larroche">Claire Larroche</name><affiliation><mods:affiliation>Service de Médecine interne, CHU Avicenne, Bobigny, France</mods:affiliation></affiliation></author><author><name sortKey="Combe, Bernard" sort="Combe, Bernard" uniqKey="Combe B" first="Bernard" last="Combe">Bernard Combe</name><affiliation><mods:affiliation>Service d'Immunorhumathologie, CHU Montpellier, Montpellier, France</mods:affiliation></affiliation></author><author><name sortKey="Hachulla, Eric" sort="Hachulla, Eric" uniqKey="Hachulla E" first="Eric" last="Hachulla">Eric Hachulla</name><affiliation><mods:affiliation>Service de Médecine interne, CHU Lille, Lille, France</mods:affiliation></affiliation></author><author><name sortKey="Meyer, Olivier" sort="Meyer, Olivier" uniqKey="Meyer O" first="Olivier" last="Meyer">Olivier Meyer</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Bichat, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Pertuiset, Edouard" sort="Pertuiset, Edouard" uniqKey="Pertuiset E" first="Edouard" last="Pertuiset">Edouard Pertuiset</name><affiliation><mods:affiliation>Service de Rhumatologie, CH Pontoise, Pontoise, France</mods:affiliation></affiliation></author><author><name sortKey="Kaplanski, Guy" sort="Kaplanski, Guy" uniqKey="Kaplanski G" first="Guy" last="Kaplanski">Guy Kaplanski</name><affiliation><mods:affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</mods:affiliation></affiliation></author><author><name sortKey="Chiche, Laurent" sort="Chiche, Laurent" uniqKey="Chiche L" first="Laurent" last="Chiche">Laurent Chiche</name><affiliation><mods:affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</mods:affiliation></affiliation></author><author><name sortKey="Berthelot, Jean Marie" sort="Berthelot, Jean Marie" uniqKey="Berthelot J" first="Jean-Marie" last="Berthelot">Jean-Marie Berthelot</name><affiliation><mods:affiliation>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes, France</mods:affiliation></affiliation></author><author><name sortKey="Gombert, Bruno" sort="Gombert, Bruno" uniqKey="Gombert B" first="Bruno" last="Gombert">Bruno Gombert</name><affiliation><mods:affiliation>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle, France</mods:affiliation></affiliation></author><author><name sortKey="Goupille, Philippe" sort="Goupille, Philippe" uniqKey="Goupille P" first="Philippe" last="Goupille">Philippe Goupille</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Tours, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Marcelli, Christian" sort="Marcelli, Christian" uniqKey="Marcelli C" first="Christian" last="Marcelli">Christian Marcelli</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU de Caen, Caen, France</mods:affiliation></affiliation></author><author><name sortKey="Feuillet, Severine" sort="Feuillet, Severine" uniqKey="Feuillet S" first="Séverine" last="Feuillet">Séverine Feuillet</name><affiliation><mods:affiliation>Service de Pneumologie, Hôpital Saint Louis, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Leone, Jean" sort="Leone, Jean" uniqKey="Leone J" first="Jean" last="Leone">Jean Leone</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Debré, Reims, France</mods:affiliation></affiliation></author><author><name sortKey="Sibilia, Jean" sort="Sibilia, Jean" uniqKey="Sibilia J" first="Jean" last="Sibilia">Jean Sibilia</name><affiliation><mods:affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Zarnitsky, Charles" sort="Zarnitsky, Charles" uniqKey="Zarnitsky C" first="Charles" last="Zarnitsky">Charles Zarnitsky</name><affiliation><mods:affiliation>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</mods:affiliation></affiliation></author><author><name sortKey="Carli, Philippe" sort="Carli, Philippe" uniqKey="Carli P" first="Philippe" last="Carli">Philippe Carli</name><affiliation><mods:affiliation>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</mods:affiliation></affiliation></author><author><name sortKey="Rist, Stephanie" sort="Rist, Stephanie" uniqKey="Rist S" first="Stephanie" last="Rist">Stephanie Rist</name><affiliation><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation></affiliation></author><author><name sortKey="Gaudin, Philippe" sort="Gaudin, Philippe" uniqKey="Gaudin P" first="Philippe" last="Gaudin">Philippe Gaudin</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</mods:affiliation></affiliation></author><author><name sortKey="Salliot, Carine" sort="Salliot, Carine" uniqKey="Salliot C" first="Carine" last="Salliot">Carine Salliot</name><affiliation><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation></affiliation></author><author><name sortKey="Piperno, Muriel" sort="Piperno, Muriel" uniqKey="Piperno M" first="Muriel" last="Piperno">Muriel Piperno</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Lyon Sud France,</mods:affiliation></affiliation></author><author><name sortKey="Deplas, Adeline" sort="Deplas, Adeline" uniqKey="Deplas A" first="Adeline" last="Deplas">Adeline Deplas</name><affiliation><mods:affiliation>Service de Rhumatologie, CH Niort, Niort France</mods:affiliation></affiliation></author><author><name sortKey="Breban, Maxime" sort="Breban, Maxime" uniqKey="Breban M" first="Maxime" last="Breban">Maxime Breban</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</mods:affiliation></affiliation></author><author><name sortKey="Lequerre, Thierry" sort="Lequerre, Thierry" uniqKey="Lequerre T" first="Thierry" last="Lequerre">Thierry Lequerre</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Rouen, Rouen, France</mods:affiliation></affiliation></author><author><name sortKey="Richette, Pascal" sort="Richette, Pascal" uniqKey="Richette P" first="Pascal" last="Richette">Pascal Richette</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Ghiringhelli, Charles" sort="Ghiringhelli, Charles" uniqKey="Ghiringhelli C" first="Charles" last="Ghiringhelli">Charles Ghiringhelli</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</mods:affiliation></affiliation></author><author><name sortKey="Hamidou, Mohamed" sort="Hamidou, Mohamed" uniqKey="Hamidou M" first="Mohamed" last="Hamidou">Mohamed Hamidou</name><affiliation><mods:affiliation>Service de Médecine Interne, CHU de Nantes, Nantes, France</mods:affiliation></affiliation></author><author><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name><affiliation><mods:affiliation>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Mariette, Xavier" sort="Mariette, Xavier" uniqKey="Mariette X" first="Xavier" last="Mariette">Xavier Mariette</name><affiliation><mods:affiliation>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:52A3B80A2058E94C2AC1BECDAEDC9D33451FAAA8</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/annrheumdis-2012-202293</idno><idno type="url">https://api.istex.fr/ark:/67375/NVC-RKMXKL43-T/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">002324</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002324</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title><author><name sortKey="Gottenberg, Jacques Eric" sort="Gottenberg, Jacques Eric" uniqKey="Gottenberg J" first="Jacques-Eric" last="Gottenberg">Jacques-Eric Gottenberg</name><affiliation><mods:affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Cinquetti, Gael" sort="Cinquetti, Gael" uniqKey="Cinquetti G" first="Gael" last="Cinquetti">Gael Cinquetti</name><affiliation><mods:affiliation>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz, France</mods:affiliation></affiliation></author><author><name sortKey="Larroche, Claire" sort="Larroche, Claire" uniqKey="Larroche C" first="Claire" last="Larroche">Claire Larroche</name><affiliation><mods:affiliation>Service de Médecine interne, CHU Avicenne, Bobigny, France</mods:affiliation></affiliation></author><author><name sortKey="Combe, Bernard" sort="Combe, Bernard" uniqKey="Combe B" first="Bernard" last="Combe">Bernard Combe</name><affiliation><mods:affiliation>Service d'Immunorhumathologie, CHU Montpellier, Montpellier, France</mods:affiliation></affiliation></author><author><name sortKey="Hachulla, Eric" sort="Hachulla, Eric" uniqKey="Hachulla E" first="Eric" last="Hachulla">Eric Hachulla</name><affiliation><mods:affiliation>Service de Médecine interne, CHU Lille, Lille, France</mods:affiliation></affiliation></author><author><name sortKey="Meyer, Olivier" sort="Meyer, Olivier" uniqKey="Meyer O" first="Olivier" last="Meyer">Olivier Meyer</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Bichat, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Pertuiset, Edouard" sort="Pertuiset, Edouard" uniqKey="Pertuiset E" first="Edouard" last="Pertuiset">Edouard Pertuiset</name><affiliation><mods:affiliation>Service de Rhumatologie, CH Pontoise, Pontoise, France</mods:affiliation></affiliation></author><author><name sortKey="Kaplanski, Guy" sort="Kaplanski, Guy" uniqKey="Kaplanski G" first="Guy" last="Kaplanski">Guy Kaplanski</name><affiliation><mods:affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</mods:affiliation></affiliation></author><author><name sortKey="Chiche, Laurent" sort="Chiche, Laurent" uniqKey="Chiche L" first="Laurent" last="Chiche">Laurent Chiche</name><affiliation><mods:affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</mods:affiliation></affiliation></author><author><name sortKey="Berthelot, Jean Marie" sort="Berthelot, Jean Marie" uniqKey="Berthelot J" first="Jean-Marie" last="Berthelot">Jean-Marie Berthelot</name><affiliation><mods:affiliation>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes, France</mods:affiliation></affiliation></author><author><name sortKey="Gombert, Bruno" sort="Gombert, Bruno" uniqKey="Gombert B" first="Bruno" last="Gombert">Bruno Gombert</name><affiliation><mods:affiliation>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle, France</mods:affiliation></affiliation></author><author><name sortKey="Goupille, Philippe" sort="Goupille, Philippe" uniqKey="Goupille P" first="Philippe" last="Goupille">Philippe Goupille</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Tours, Tours, France</mods:affiliation></affiliation></author><author><name sortKey="Marcelli, Christian" sort="Marcelli, Christian" uniqKey="Marcelli C" first="Christian" last="Marcelli">Christian Marcelli</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU de Caen, Caen, France</mods:affiliation></affiliation></author><author><name sortKey="Feuillet, Severine" sort="Feuillet, Severine" uniqKey="Feuillet S" first="Séverine" last="Feuillet">Séverine Feuillet</name><affiliation><mods:affiliation>Service de Pneumologie, Hôpital Saint Louis, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Leone, Jean" sort="Leone, Jean" uniqKey="Leone J" first="Jean" last="Leone">Jean Leone</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Debré, Reims, France</mods:affiliation></affiliation></author><author><name sortKey="Sibilia, Jean" sort="Sibilia, Jean" uniqKey="Sibilia J" first="Jean" last="Sibilia">Jean Sibilia</name><affiliation><mods:affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Zarnitsky, Charles" sort="Zarnitsky, Charles" uniqKey="Zarnitsky C" first="Charles" last="Zarnitsky">Charles Zarnitsky</name><affiliation><mods:affiliation>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</mods:affiliation></affiliation></author><author><name sortKey="Carli, Philippe" sort="Carli, Philippe" uniqKey="Carli P" first="Philippe" last="Carli">Philippe Carli</name><affiliation><mods:affiliation>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</mods:affiliation></affiliation></author><author><name sortKey="Rist, Stephanie" sort="Rist, Stephanie" uniqKey="Rist S" first="Stephanie" last="Rist">Stephanie Rist</name><affiliation><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation></affiliation></author><author><name sortKey="Gaudin, Philippe" sort="Gaudin, Philippe" uniqKey="Gaudin P" first="Philippe" last="Gaudin">Philippe Gaudin</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</mods:affiliation></affiliation></author><author><name sortKey="Salliot, Carine" sort="Salliot, Carine" uniqKey="Salliot C" first="Carine" last="Salliot">Carine Salliot</name><affiliation><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation></affiliation></author><author><name sortKey="Piperno, Muriel" sort="Piperno, Muriel" uniqKey="Piperno M" first="Muriel" last="Piperno">Muriel Piperno</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Lyon Sud France,</mods:affiliation></affiliation></author><author><name sortKey="Deplas, Adeline" sort="Deplas, Adeline" uniqKey="Deplas A" first="Adeline" last="Deplas">Adeline Deplas</name><affiliation><mods:affiliation>Service de Rhumatologie, CH Niort, Niort France</mods:affiliation></affiliation></author><author><name sortKey="Breban, Maxime" sort="Breban, Maxime" uniqKey="Breban M" first="Maxime" last="Breban">Maxime Breban</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</mods:affiliation></affiliation></author><author><name sortKey="Lequerre, Thierry" sort="Lequerre, Thierry" uniqKey="Lequerre T" first="Thierry" last="Lequerre">Thierry Lequerre</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Rouen, Rouen, France</mods:affiliation></affiliation></author><author><name sortKey="Richette, Pascal" sort="Richette, Pascal" uniqKey="Richette P" first="Pascal" last="Richette">Pascal Richette</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Ghiringhelli, Charles" sort="Ghiringhelli, Charles" uniqKey="Ghiringhelli C" first="Charles" last="Ghiringhelli">Charles Ghiringhelli</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</mods:affiliation></affiliation></author><author><name sortKey="Hamidou, Mohamed" sort="Hamidou, Mohamed" uniqKey="Hamidou M" first="Mohamed" last="Hamidou">Mohamed Hamidou</name><affiliation><mods:affiliation>Service de Médecine Interne, CHU de Nantes, Nantes, France</mods:affiliation></affiliation></author><author><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name><affiliation><mods:affiliation>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Mariette, Xavier" sort="Mariette, Xavier" uniqKey="Mariette X" first="Xavier" last="Mariette">Xavier Mariette</name><affiliation><mods:affiliation>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2013-06">2013-06</date><biblScope unit="volume">72</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1026">1026</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Autoimmune</term><term>Autoimmune diseases</term><term>Autoimmune pancreatitis</term><term>Club rhumatismes</term><term>Common practice</term><term>Corticosteroid</term><term>Data collection</term><term>Essdai</term><term>French society</term><term>Immunosuppressant</term><term>Infusion</term><term>Lymphoma</term><term>Median</term><term>Present study</term><term>Primary syndrome</term><term>Registry</term><term>Renal involvement</term><term>Rheum</term><term>Rheumatoid arthritis</term><term>Rheumatology</term><term>Rhumatologie</term><term>Rituximab</term><term>Rituximab regimen</term><term>Rituximab registry</term><term>Second cycle</term><term>Second infusion</term><term>Serious infections</term><term>Serum disease</term><term>Syndrome</term><term>Systemic</term><term>Systemic complications</term><term>Systemic involvement</term><term>Systemic lupus erythematosus</term><term>Vasculitis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objectives To evaluate the efficacy and safety of rituximab in patients with primary Sjögren's syndrome (pSS). Methods The AutoImmune and Rituximab registry has included 86 patients with pSS treated with rituximab, prospectivey followed up every 6 months for 5 years. Results Seventy-eight patients with pSS (11 men, 67 women), who already had at least one follow-up visit, were analysed. Median age was 59.8 years (29–83), median duration of disease was 11.9 years (3–32). Indications for treatment were systemic involvement for 74 patients and only severe glandular involvement in four patients. The median European Sjögren's Syndrome disease activity index (ESSDAI) was 11 (2–31). 17 patients were concomitantly treated with another immunosuppressant agent. Median follow-up was 34.9 months (6–81.4) (226 patient-years). Overall efficacy according to the treating physician was observed in 47 patients (60%) after the first cycle of rituximab. Median ESSDAI decreased from 11 (2–31) to 7.5 (0–26) (p<0.0001). Median dosage of corticosteroid decreased from 17.6 mg/day (3–60) to 10.8 mg/day (p=0.1). Forty-one patients were retreated with rituximab. Four infusion reactions and one delayed serum sickness-like disease resulted in rituximab discontinuation. Three serious infections (1.3/100 patient-years) and two cancer-related deaths occurred. Conclusions In common practice, the use of rituximab in pSS is mostly restricted to patients with systemic involvement. This prospective study shows good efficacy and tolerance of rituximab in patients with pSS and systemic involvement.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>rituximab</json:string><json:string>autoimmune</json:string><json:string>rhumatologie</json:string><json:string>systemic involvement</json:string><json:string>corticosteroid</json:string><json:string>vasculitis</json:string><json:string>essdai</json:string><json:string>primary syndrome</json:string><json:string>rheum</json:string><json:string>median</json:string><json:string>rheumatology</json:string><json:string>immunosuppressant</json:string><json:string>infusion</json:string><json:string>present study</json:string><json:string>systemic</json:string><json:string>serious infections</json:string><json:string>systemic complications</json:string><json:string>rituximab registry</json:string><json:string>syndrome</json:string><json:string>second cycle</json:string><json:string>french society</json:string><json:string>data collection</json:string><json:string>club rhumatismes</json:string><json:string>lymphoma</json:string><json:string>rituximab regimen</json:string><json:string>autoimmune diseases</json:string><json:string>systemic lupus erythematosus</json:string><json:string>renal involvement</json:string><json:string>rheumatoid arthritis</json:string><json:string>autoimmune pancreatitis</json:string><json:string>second infusion</json:string><json:string>common practice</json:string><json:string>serum disease</json:string><json:string>registry</json:string><json:string>disease activity</json:string><json:string>global opinion</json:string><json:string>systemic complication</json:string><json:string>adverse events</json:string><json:string>continuous variables</json:string><json:string>qualitative variables</json:string><json:string>articular involvement</json:string><json:string>infusion reactions</json:string><json:string>pulmonary involvement</json:string><json:string>bronchial involvement</json:string><json:string>median essdai</json:string><json:string>autoimmune cytopaenias</json:string><json:string>autoimmune anaemia</json:string><json:string>median dosage</json:string><json:string>rituximab corticosteroids</json:string><json:string>systemic manifestations</json:string><json:string>other immunosuppressant agent</json:string><json:string>monoclonal antibody</json:string><json:string>open study rituximab</json:string><json:string>days none</json:string><json:string>rituximab group</json:string><json:string>days weeks</json:string><json:string>commission nationale</json:string><json:string>rituximab initiation</json:string><json:string>observational design</json:string><json:string>epidemiological research</json:string><json:string>french autoimmunity</json:string></teeft></keywords><author><json:item><name>Jacques-Eric Gottenberg</name><affiliations><json:string>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</json:string></affiliations></json:item><json:item><name>Gael Cinquetti</name><affiliations><json:string>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz, France</json:string></affiliations></json:item><json:item><name>Claire Larroche</name><affiliations><json:string>Service de Médecine interne, CHU Avicenne, Bobigny, France</json:string></affiliations></json:item><json:item><name>Bernard Combe</name><affiliations><json:string>Service d'Immunorhumathologie, CHU Montpellier, Montpellier, France</json:string></affiliations></json:item><json:item><name>Eric Hachulla</name><affiliations><json:string>Service de Médecine interne, CHU Lille, Lille, France</json:string></affiliations></json:item><json:item><name>Olivier Meyer</name><affiliations><json:string>Service de Rhumatologie, Hôpital Bichat, Paris, France</json:string></affiliations></json:item><json:item><name>Edouard Pertuiset</name><affiliations><json:string>Service de Rhumatologie, CH Pontoise, Pontoise, France</json:string></affiliations></json:item><json:item><name>Guy Kaplanski</name><affiliations><json:string>Service de Médecine interne, Hôpital de la conception, Marseille, France</json:string></affiliations></json:item><json:item><name>Laurent Chiche</name><affiliations><json:string>Service de Médecine interne, Hôpital de la conception, Marseille, France</json:string></affiliations></json:item><json:item><name>Jean-Marie Berthelot</name><affiliations><json:string>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes, France</json:string></affiliations></json:item><json:item><name>Bruno Gombert</name><affiliations><json:string>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle, France</json:string></affiliations></json:item><json:item><name>Philippe Goupille</name><affiliations><json:string>Service de Rhumatologie, CHU Tours, Tours, France</json:string></affiliations></json:item><json:item><name>Christian Marcelli</name><affiliations><json:string>Service de Rhumatologie, CHU de Caen, Caen, France</json:string></affiliations></json:item><json:item><name>Séverine Feuillet</name><affiliations><json:string>Service de Pneumologie, Hôpital Saint Louis, Paris, France</json:string></affiliations></json:item><json:item><name>Jean Leone</name><affiliations><json:string>Service de Médecine Interne, Hôpital Debré, Reims, France</json:string></affiliations></json:item><json:item><name>Jean Sibilia</name><affiliations><json:string>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</json:string></affiliations></json:item><json:item><name>Charles Zarnitsky</name><affiliations><json:string>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</json:string></affiliations></json:item><json:item><name>Philippe Carli</name><affiliations><json:string>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</json:string></affiliations></json:item><json:item><name>Stephanie Rist</name><affiliations><json:string>Service de Rhumatologie, CHR Orléans, Orléans, France</json:string></affiliations></json:item><json:item><name>Philippe Gaudin</name><affiliations><json:string>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</json:string></affiliations></json:item><json:item><name>Carine Salliot</name><affiliations><json:string>Service de Rhumatologie, CHR Orléans, Orléans, France</json:string></affiliations></json:item><json:item><name>Muriel Piperno</name><affiliations><json:string>Service de Rhumatologie, CHU Lyon Sud France,</json:string></affiliations></json:item><json:item><name>Adeline Deplas</name><affiliations><json:string>Service de Rhumatologie, CH Niort, Niort France</json:string></affiliations></json:item><json:item><name>Maxime Breban</name><affiliations><json:string>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</json:string></affiliations></json:item><json:item><name>Thierry Lequerre</name><affiliations><json:string>Service de Rhumatologie, CHU Rouen, Rouen, France</json:string></affiliations></json:item><json:item><name>Pascal Richette</name><affiliations><json:string>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</json:string></affiliations></json:item><json:item><name>Charles Ghiringhelli</name><affiliations><json:string>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</json:string></affiliations></json:item><json:item><name>Mohamed Hamidou</name><affiliations><json:string>Service de Médecine Interne, CHU de Nantes, Nantes, France</json:string></affiliations></json:item><json:item><name>Philippe Ravaud</name><affiliations><json:string>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</json:string></affiliations></json:item><json:item><name>Xavier Mariette</name><affiliations><json:string>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Sjøgren's Syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Autoimmunity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Autoimmune Diseases</value></json:item></subject><articleId><json:string>annrheumdis-2012-202293</json:string></articleId><arkIstex>ark:/67375/NVC-RKMXKL43-T</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Objectives To evaluate the efficacy and safety of rituximab in patients with primary Sjögren's syndrome (pSS). Methods The AutoImmune and Rituximab registry has included 86 patients with pSS treated with rituximab, prospectivey followed up every 6 months for 5 years. Results Seventy-eight patients with pSS (11 men, 67 women), who already had at least one follow-up visit, were analysed. Median age was 59.8 years (29–83), median duration of disease was 11.9 years (3–32). Indications for treatment were systemic involvement for 74 patients and only severe glandular involvement in four patients. The median European Sjögren's Syndrome disease activity index (ESSDAI) was 11 (2–31). 17 patients were concomitantly treated with another immunosuppressant agent. Median follow-up was 34.9 months (6–81.4) (226 patient-years). Overall efficacy according to the treating physician was observed in 47 patients (60%) after the first cycle of rituximab. Median ESSDAI decreased from 11 (2–31) to 7.5 (0–26) (p>0.0001). Median dosage of corticosteroid decreased from 17.6 mg/day (3–60) to 10.8 mg/day (p=0.1). Forty-one patients were retreated with rituximab. Four infusion reactions and one delayed serum sickness-like disease resulted in rituximab discontinuation. Three serious infections (1.3/100 patient-years) and two cancer-related deaths occurred. Conclusions In common practice, the use of rituximab in pSS is mostly restricted to patients with systemic involvement. This prospective study shows good efficacy and tolerance of rituximab in patients with pSS and systemic involvement.</abstract><qualityIndicators><score>8.73</score><pdfWordCount>4138</pdfWordCount><pdfCharCount>29772</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>216</abstractWordCount><abstractCharCount>1584</abstractCharCount><keywordCount>3</keywordCount></qualityIndicators><title>Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title><pmid><json:string>23264337</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Annals of the Rheumatic Diseases</title><language><json:string>unknown</json:string></language><issn><json:string>0003-4967</json:string></issn><eissn><json:string>1468-2060</json:string></eissn><publisherId><json:string>ard</json:string></publisherId><volume>72</volume><issue>6</issue><pages><first>1026</first></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2012-12-21</json:string><json:string>3662</json:string></date><geogName></geogName><orgName><json:string>SNFMI</json:string><json:string>France Service</json:string><json:string>France Ann Rheum Dis</json:string><json:string>French National Society of Internal Medicine</json:string><json:string>Santé and Commission Nationale</json:string><json:string>French Society of Rheumatology</json:string><json:string>SFR</json:string></orgName><orgName_funder><json:string>French Society of Rheumatology</json:string><json:string>SFR</json:string></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Jacques-Eric Gottenberg</json:string><json:string>Rosemary Jourdan</json:string><json:string>Bernard Combe</json:string><json:string>Mohamed Hamidou</json:string><json:string>Jamila Filipecki</json:string><json:string>Ann Rheum</json:string><json:string>Stephanie Rist</json:string><json:string>CHU Rouen</json:string><json:string>Isabelle Pane</json:string><json:string>Charles Zarnitsky</json:string><json:string>Philippe Carli</json:string><json:string>Adeline Deplas</json:string><json:string>Interne</json:string><json:string>Gael Cinquetti</json:string><json:string>Philippe Goupille</json:string><json:string>Nadine Mackenzie</json:string><json:string>Olivier Meyer</json:string><json:string>Philippe Ravaud</json:string><json:string>CHU Avicenne</json:string><json:string>Carine Salliot</json:string><json:string>Eric Hachulla</json:string><json:string>Philippe Gaudin</json:string><json:string>Claire Larroche</json:string><json:string>Maxime Breban</json:string><json:string>Paris Sud</json:string><json:string>Thierry Lequerre</json:string><json:string>Xavier Mariette</json:string><json:string>CHU Hôpital</json:string><json:string>Charles Ghiringhelli</json:string><json:string>La Rochelle</json:string><json:string>Muriel Piperno</json:string><json:string>Laurent Chiche</json:string><json:string>Guy Kaplanski</json:string><json:string>Jean Leone</json:string><json:string>Jean Sibilia</json:string><json:string>Pascal Richette</json:string><json:string>Christian Marcelli</json:string><json:string>Bruno Gombert</json:string><json:string>CHU Ambroise</json:string><json:string>Séverine Feuillet</json:string><json:string>Edouard Pertuiset</json:string><json:string>CHU Tours</json:string></persName><placeName><json:string>Le Havre</json:string><json:string>Paris</json:string><json:string>Montpellier</json:string><json:string>Bordeaux</json:string><json:string>Caen</json:string><json:string>Boulogne Billancourt</json:string><json:string>Grenoble</json:string><json:string>Toulon</json:string><json:string>Reims</json:string><json:string>Nantes</json:string><json:string>Rouen</json:string><json:string>Strasbourg</json:string><json:string>Metz</json:string><json:string>La Rochelle</json:string><json:string>France</json:string><json:string>Marseille</json:string><json:string>Saint André</json:string><json:string>Lille</json:string><json:string>Lyon</json:string><json:string>Tours</json:string></placeName><ref_url></ref_url><ref_bibl><json:string>Pijpe et al</json:string><json:string>Terrier et al</json:string><json:string>Gottenberg et al</json:string><json:string>Dass et al</json:string><json:string>Tony et al</json:string><json:string>Meijer et al</json:string><json:string>Ramos-Casals et al</json:string><json:string>Devauchelle-Pensec et al</json:string><json:string>Mekinian et al</json:string><json:string>Seror et al</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-RKMXKL43-T</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - rheumatology</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - clinical medicine</json:string><json:string>3 - arthritis & rheumatology</json:string></scienceMetrix><scopus><json:string>1 - Life Sciences</json:string><json:string>2 - Biochemistry, Genetics and Molecular Biology</json:string><json:string>3 - General Biochemistry, Genetics and Molecular Biology</json:string><json:string>1 - Life Sciences</json:string><json:string>2 - Immunology and Microbiology</json:string><json:string>3 - Immunology</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Immunology and Allergy</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Rheumatology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1136/annrheumdis-2012-202293</json:string></doi><id>52A3B80A2058E94C2AC1BECDAEDC9D33451FAAA8</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-RKMXKL43-T/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-RKMXKL43-T/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/NVC-RKMXKL43-T/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a">Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><availability><licence><p>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2012-12-21</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note><note>J-EG and GC contributed equally to this study.</note><note>Correspondence to Professor Jacques-Eric Gottenberg, ImmunoRhumatologie Moléculaire, Service de Rhumatologie, INSERM UMR_S 1109, Université de Strasbourg, Centre National de Référence des Maladies Auto-Immunes, Hôpital Hautepierre, 1 Avenue Molière, 67000 Strasbourg 67098, France; jacques-eric.gottenberg@chru-strasbourg.fr</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title><author xml:id="author-0000"><persName><forename type="first">Jacques-Eric</forename><surname>Gottenberg</surname></persName><affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Gael</forename><surname>Cinquetti</surname></persName><affiliation>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz, France</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Claire</forename><surname>Larroche</surname></persName><affiliation>Service de Médecine interne, CHU Avicenne, Bobigny, France</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Bernard</forename><surname>Combe</surname></persName><affiliation>Service d'Immunorhumathologie, CHU Montpellier, Montpellier, France</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Eric</forename><surname>Hachulla</surname></persName><affiliation>Service de Médecine interne, CHU Lille, Lille, France</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Olivier</forename><surname>Meyer</surname></persName><affiliation>Service de Rhumatologie, Hôpital Bichat, Paris, France</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Edouard</forename><surname>Pertuiset</surname></persName><affiliation>Service de Rhumatologie, CH Pontoise, Pontoise, France</affiliation></author><author xml:id="author-0007"><persName><forename type="first">Guy</forename><surname>Kaplanski</surname></persName><affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</affiliation></author><author xml:id="author-0008"><persName><forename type="first">Laurent</forename><surname>Chiche</surname></persName><affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</affiliation></author><author xml:id="author-0009"><persName><forename type="first">Jean-Marie</forename><surname>Berthelot</surname></persName><affiliation>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes, France</affiliation></author><author xml:id="author-0010"><persName><forename type="first">Bruno</forename><surname>Gombert</surname></persName><affiliation>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle, France</affiliation></author><author xml:id="author-0011"><persName><forename type="first">Philippe</forename><surname>Goupille</surname></persName><affiliation>Service de Rhumatologie, CHU Tours, Tours, France</affiliation></author><author xml:id="author-0012"><persName><forename type="first">Christian</forename><surname>Marcelli</surname></persName><affiliation>Service de Rhumatologie, CHU de Caen, Caen, France</affiliation></author><author xml:id="author-0013"><persName><forename type="first">Séverine</forename><surname>Feuillet</surname></persName><affiliation>Service de Pneumologie, Hôpital Saint Louis, Paris, France</affiliation></author><author xml:id="author-0014"><persName><forename type="first">Jean</forename><surname>Leone</surname></persName><affiliation>Service de Médecine Interne, Hôpital Debré, Reims, France</affiliation></author><author xml:id="author-0015"><persName><forename type="first">Jean</forename><surname>Sibilia</surname></persName><affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</affiliation></author><author xml:id="author-0016"><persName><forename type="first">Charles</forename><surname>Zarnitsky</surname></persName><affiliation>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</affiliation></author><author xml:id="author-0017"><persName><forename type="first">Philippe</forename><surname>Carli</surname></persName><affiliation>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</affiliation></author><author xml:id="author-0018"><persName><forename type="first">Stephanie</forename><surname>Rist</surname></persName><affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</affiliation></author><author xml:id="author-0019"><persName><forename type="first">Philippe</forename><surname>Gaudin</surname></persName><affiliation>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</affiliation></author><author xml:id="author-0020"><persName><forename type="first">Carine</forename><surname>Salliot</surname></persName><affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</affiliation></author><author xml:id="author-0021"><persName><forename type="first">Muriel</forename><surname>Piperno</surname></persName><affiliation>Service de Rhumatologie, CHU Lyon Sud France,</affiliation></author><author xml:id="author-0022"><persName><forename type="first">Adeline</forename><surname>Deplas</surname></persName><affiliation>Service de Rhumatologie, CH Niort, Niort France</affiliation></author><author xml:id="author-0023"><persName><forename type="first">Maxime</forename><surname>Breban</surname></persName><affiliation>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</affiliation></author><author xml:id="author-0024"><persName><forename type="first">Thierry</forename><surname>Lequerre</surname></persName><affiliation>Service de Rhumatologie, CHU Rouen, Rouen, France</affiliation></author><author xml:id="author-0025"><persName><forename type="first">Pascal</forename><surname>Richette</surname></persName><affiliation>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</affiliation></author><author xml:id="author-0026"><persName><forename type="first">Charles</forename><surname>Ghiringhelli</surname></persName><affiliation>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</affiliation></author><author xml:id="author-0027"><persName><forename type="first">Mohamed</forename><surname>Hamidou</surname></persName><affiliation>Service de Médecine Interne, CHU de Nantes, Nantes, France</affiliation></author><author xml:id="author-0028"><persName><forename type="first">Philippe</forename><surname>Ravaud</surname></persName><affiliation>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</affiliation></author><author xml:id="author-0029"><persName><forename type="first">Xavier</forename><surname>Mariette</surname></persName><affiliation>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</affiliation></author><idno type="istex">52A3B80A2058E94C2AC1BECDAEDC9D33451FAAA8</idno><idno type="ark">ark:/67375/NVC-RKMXKL43-T</idno><idno type="DOI">10.1136/annrheumdis-2012-202293</idno><idno type="href">annrheumdis-72-1026.pdf</idno><idno type="article-id">annrheumdis-2012-202293</idno><idno type="PMID">23264337</idno><idno type="local">annrheumdis;72/6/1026</idno></analytic><monogr><title level="j">Annals of the Rheumatic Diseases</title><title level="j" type="abbrev">Ann Rheum Dis</title><idno type="pISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><idno type="publisher-id">ard</idno><idno type="PublisherID-hwp">annrheumdis</idno><idno type="PublisherID-nlm-ta">Ann Rheum Dis</idno><imprint><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><date type="published" when="2013-06"></date><biblScope unit="volume">72</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1026">1026</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2012-12-21</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objectives To evaluate the efficacy and safety of rituximab in patients with primary Sjögren's syndrome (pSS). Methods The AutoImmune and Rituximab registry has included 86 patients with pSS treated with rituximab, prospectivey followed up every 6 months for 5 years. Results Seventy-eight patients with pSS (11 men, 67 women), who already had at least one follow-up visit, were analysed. Median age was 59.8 years (29–83), median duration of disease was 11.9 years (3–32). Indications for treatment were systemic involvement for 74 patients and only severe glandular involvement in four patients. The median European Sjögren's Syndrome disease activity index (ESSDAI) was 11 (2–31). 17 patients were concomitantly treated with another immunosuppressant agent. Median follow-up was 34.9 months (6–81.4) (226 patient-years). Overall efficacy according to the treating physician was observed in 47 patients (60%) after the first cycle of rituximab. Median ESSDAI decreased from 11 (2–31) to 7.5 (0–26) (p<0.0001). Median dosage of corticosteroid decreased from 17.6 mg/day (3–60) to 10.8 mg/day (p=0.1). Forty-one patients were retreated with rituximab. Four infusion reactions and one delayed serum sickness-like disease resulted in rituximab discontinuation. Three serious infections (1.3/100 patient-years) and two cancer-related deaths occurred. Conclusions In common practice, the use of rituximab in pSS is mostly restricted to patients with systemic involvement. This prospective study shows good efficacy and tolerance of rituximab in patients with pSS and systemic involvement.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>Sjøgren's Syndrome</term></item><item><term>Autoimmunity</term></item><item><term>Autoimmune Diseases</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2012-12-21">Created</change><change when="2013-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-RKMXKL43-T/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">annrheumdis</journal-id><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id><journal-id journal-id-type="publisher-id">ard</journal-id><journal-title>Annals of the Rheumatic Diseases</journal-title><abbrev-journal-title abbrev-type="publisher">Ann Rheum Dis</abbrev-journal-title><abbrev-journal-title>Ann Rheum Dis</abbrev-journal-title><issn pub-type="ppub">0003-4967</issn><issn pub-type="epub">1468-2060</issn><publisher><publisher-name>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">annrheumdis-2012-202293</article-id><article-id pub-id-type="doi">10.1136/annrheumdis-2012-202293</article-id><article-id pub-id-type="other">annrheumdis;72/6/1026</article-id><article-id pub-id-type="other">annrheumdis;annrheumdis-2012-202293</article-id><article-id pub-id-type="pmid">23264337</article-id><article-id pub-id-type="other">1026</article-id><article-id pub-id-type="other">annrheumdis-2012-202293</article-id><article-categories><subj-group subj-group-type="heading"><subject>Clinical and epidemiological research</subject></subj-group><series-title>Concise report</series-title></article-categories><title-group><article-title>Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Gottenberg</surname><given-names>Jacques-Eric</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Cinquetti</surname><given-names>Gael</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Larroche</surname><given-names>Claire</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Combe</surname><given-names>Bernard</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Hachulla</surname><given-names>Eric</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Meyer</surname><given-names>Olivier</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Pertuiset</surname><given-names>Edouard</given-names></name><xref ref-type="aff" rid="af7">7</xref></contrib><contrib contrib-type="author"><name><surname>Kaplanski</surname><given-names>Guy</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib><contrib contrib-type="author"><name><surname>Chiche</surname><given-names>Laurent</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib><contrib contrib-type="author"><name><surname>Berthelot</surname><given-names>Jean-Marie</given-names></name><xref ref-type="aff" rid="af9">9</xref></contrib><contrib contrib-type="author"><name><surname>Gombert</surname><given-names>Bruno</given-names></name><xref ref-type="aff" rid="af10">10</xref></contrib><contrib contrib-type="author"><name><surname>Goupille</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="af11">11</xref></contrib><contrib contrib-type="author"><name><surname>Marcelli</surname><given-names>Christian</given-names></name><xref ref-type="aff" rid="af12">12</xref></contrib><contrib contrib-type="author"><name><surname>Feuillet</surname><given-names>Séverine</given-names></name><xref ref-type="aff" rid="af13">13</xref></contrib><contrib contrib-type="author"><name><surname>Leone</surname><given-names>Jean</given-names></name><xref ref-type="aff" rid="af14">14</xref></contrib><contrib contrib-type="author"><name><surname>Sibilia</surname><given-names>Jean</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Zarnitsky</surname><given-names>Charles</given-names></name><xref ref-type="aff" rid="af15">15</xref></contrib><contrib contrib-type="author"><name><surname>Carli</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="af16">16</xref></contrib><contrib contrib-type="author"><name><surname>Rist</surname><given-names>Stephanie</given-names></name><xref ref-type="aff" rid="af17">17</xref></contrib><contrib contrib-type="author"><name><surname>Gaudin</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="af18">18</xref></contrib><contrib contrib-type="author"><name><surname>Salliot</surname><given-names>Carine</given-names></name><xref ref-type="aff" rid="af17">17</xref></contrib><contrib contrib-type="author"><name><surname>Piperno</surname><given-names>Muriel</given-names></name><xref ref-type="aff" rid="af19">19</xref></contrib><contrib contrib-type="author"><name><surname>Deplas</surname><given-names>Adeline</given-names></name><xref ref-type="aff" rid="af20">20</xref></contrib><contrib contrib-type="author"><name><surname>Breban</surname><given-names>Maxime</given-names></name><xref ref-type="aff" rid="af21">21</xref></contrib><contrib contrib-type="author"><name><surname>Lequerre</surname><given-names>Thierry</given-names></name><xref ref-type="aff" rid="af22">22</xref></contrib><contrib contrib-type="author"><name><surname>Richette</surname><given-names>Pascal</given-names></name><xref ref-type="aff" rid="af23">23</xref></contrib><contrib contrib-type="author"><name><surname>Ghiringhelli</surname><given-names>Charles</given-names></name><xref ref-type="aff" rid="af24">24</xref></contrib><contrib contrib-type="author"><name><surname>Hamidou</surname><given-names>Mohamed</given-names></name><xref ref-type="aff" rid="af25">25</xref></contrib><contrib contrib-type="author"><name><surname>Ravaud</surname><given-names>Philippe</given-names></name><xref ref-type="aff" rid="af26">26</xref></contrib><contrib contrib-type="author"><name><surname>Mariette</surname><given-names>Xavier</given-names></name><xref ref-type="aff" rid="af27">27</xref></contrib><contrib contrib-type="contributor"><on-behalf-of>for the Club Rhumatismes et Inflammations and the French Society of Rheumatology</on-behalf-of></contrib></contrib-group><aff id="af1"><label>1</label>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</aff><aff id="af2"><label>2</label><addr-line>Service de Médecine Interne et Maladies Infectieuses</addr-line>, <institution>HIA Legouest</institution>, <addr-line>Metz</addr-line>, <country>France</country></aff><aff id="af3"><label>3</label><addr-line>Service de Médecine interne</addr-line>, <institution>CHU Avicenne</institution>, <addr-line>Bobigny</addr-line>, <country>France</country></aff><aff id="af4"><label>4</label><addr-line>Service d'Immunorhumathologie</addr-line>, <institution>CHU Montpellier</institution>, <addr-line>Montpellier</addr-line>, <country>France</country></aff><aff id="af5"><label>5</label><addr-line>Service de Médecine interne</addr-line>, <institution>CHU Lille</institution>, <addr-line>Lille</addr-line>, <country>France</country></aff><aff id="af6"><label>6</label><addr-line>Service de Rhumatologie</addr-line>, <institution>Hôpital Bichat</institution>, <addr-line>Paris</addr-line>, <country>France</country></aff><aff id="af7"><label>7</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CH Pontoise</institution>, <addr-line>Pontoise</addr-line>, <country>France</country></aff><aff id="af8"><label>8</label><institution>Service de Médecine interne, Hôpital de la conception</institution>, <addr-line>Marseille</addr-line>, <country>France</country></aff><aff id="af9"><label>9</label><addr-line>Service de Rhumatologie, INSERM U957</addr-line>, <institution>CHU Nantes</institution>, <addr-line>Nantes</addr-line>, <country>France</country></aff><aff id="af10"><label>10</label><addr-line>Service de Médecine Polyvalente - Rhumatologie</addr-line>, <institution>CH de La Rochelle</institution>, <institution>La Rochelle</institution>, <country>France</country></aff><aff id="af11"><label>11</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CHU Tours</institution>, <addr-line>Tours</addr-line>, <country>France</country></aff><aff id="af12"><label>12</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CHU de Caen</institution>, <addr-line>Caen</addr-line>, <country>France</country></aff><aff id="af13"><label>13</label><addr-line>Service de Pneumologie</addr-line>, <institution>Hôpital Saint Louis</institution>, <addr-line>Paris</addr-line>, <country>France</country></aff><aff id="af14"><label>14</label><addr-line>Service de Médecine Interne</addr-line>, <institution>Hôpital Debré</institution>, <addr-line>Reims</addr-line>, <country>France</country></aff><aff id="af15"><label>15</label><institution>Service de Rhumatologie, Groupe Hospitalier du Havre</institution>, <addr-line>Le Havre</addr-line>, <country>France</country></aff><aff id="af16"><label>16</label><addr-line>Service de Médecine Interne</addr-line>, <institution>HIA Sainte-Anne</institution>, <addr-line>Toulon</addr-line>, <country>France</country></aff><aff id="af17"><label>17</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CHR Orléans</institution>, <addr-line>Orléans</addr-line>, <country>France</country></aff><aff id="af18"><label>18</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CHU Hôpital Sud, Grenoble</institution>, <addr-line>Echirolles</addr-line>, <country>France</country></aff><aff id="af19"><label>19</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CHU Lyon Sud France</institution>, </aff><aff id="af20"><label>20</label><addr-line>Service de Rhumatologie</addr-line>, <institution>CH Niort</institution>, <country>Niort France</country></aff><aff id="af21"><label>21</label>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</aff><aff id="af22"><label>22</label>Service de Rhumatologie, CHU Rouen, Rouen, France</aff><aff id="af23"><label>23</label>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</aff><aff id="af24"><label>24</label>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</aff><aff id="af25"><label>25</label>Service de Médecine Interne, CHU de Nantes, Nantes, France</aff><aff id="af26"><label>26</label><addr-line>INSERM U738, Département d'Epidémiologie</addr-line>, <institution>Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique</institution>, <addr-line>Paris</addr-line>, <country>France</country></aff><aff id="af27"><label>27</label><addr-line>Service de Rhumatologie, Université Paris Sud</addr-line>, <institution>AP-HP, Hôpitaux Universitaires Paris Sud</institution>, <addr-line>Paris</addr-line>, <country>France</country></aff><author-notes><corresp><label>Correspondence to</label> Professor Jacques-Eric Gottenberg, ImmunoRhumatologie Moléculaire, Service de Rhumatologie, INSERM UMR_S 1109, Université de Strasbourg, Centre National de Référence des Maladies Auto-Immunes, Hôpital Hautepierre, 1 Avenue Molière, 67000 Strasbourg 67098, France; jacques-eric.gottenberg@chru-strasbourg.fr
</corresp><fn><p>J-EG and GC contributed equally to this study.</p></fn></author-notes><pub-date pub-type="ppub"><month>6</month><year>2013</year></pub-date><pub-date pub-type="epub-original"><day>21</day><month>12</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>21</day><month>12</month><year>2012</year></pub-date><volume>72</volume><volume-id pub-id-type="other">72</volume-id><volume-id pub-id-type="other">72</volume-id><issue>6</issue><issue-id pub-id-type="other">annrheumdis;72/6</issue-id><issue-id pub-id-type="other">6</issue-id><issue-id pub-id-type="other">72/6</issue-id><fpage>1026</fpage><history><date date-type="received"><day>2</day><month>7</month><year>2012</year></date><date date-type="rev-recd"><day>12</day><month>10</month><year>2012</year></date><date date-type="accepted"><day>18</day><month>11</month><year>2012</year></date></history><permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="annrheumdis-72-1026.pdf"></self-uri><abstract><sec><title>Objectives</title><p>To evaluate the efficacy and safety of rituximab in patients with primary Sjögren's syndrome (pSS).</p></sec><sec><title>Methods</title><p>The AutoImmune and Rituximab registry has included 86 patients with pSS treated with rituximab, prospectivey followed up every 6 months for 5 years.</p></sec><sec><title>Results</title><p>Seventy-eight patients with pSS (11 men, 67 women), who already had at least one follow-up visit, were analysed. Median age was 59.8 years (29–83), median duration of disease was 11.9 years (3–32). Indications for treatment were systemic involvement for 74 patients and only severe glandular involvement in four patients. The median European Sjögren's Syndrome disease activity index (ESSDAI) was 11 (2–31). 17 patients were concomitantly treated with another immunosuppressant agent. Median follow-up was 34.9 months (6–81.4) (226 patient-years). Overall efficacy according to the treating physician was observed in 47 patients (60%) after the first cycle of rituximab. Median ESSDAI decreased from 11 (2–31) to 7.5 (0–26) (p<0.0001). Median dosage of corticosteroid decreased from 17.6 mg/day (3–60) to 10.8 mg/day (p=0.1). Forty-one patients were retreated with rituximab. Four infusion reactions and one delayed serum sickness-like disease resulted in rituximab discontinuation. Three serious infections (1.3/100 patient-years) and two cancer-related deaths occurred.</p></sec><sec><title>Conclusions</title><p>In common practice, the use of rituximab in pSS is mostly restricted to patients with systemic involvement. This prospective study shows good efficacy and tolerance of rituximab in patients with pSS and systemic involvement.</p></sec></abstract><kwd-group><kwd>Sjøgren's Syndrome</kwd><kwd>Autoimmunity</kwd><kwd>Autoimmune Diseases</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title><partName>Concise report</partName></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Efficacy of rituximab in systemic manifestations of primary Sjögren's syndrome: results in 78 patients of the AutoImmune and Rituximab registry</title><partName>Concise report</partName></titleInfo><name type="personal"><namePart type="given">Jacques-Eric</namePart><namePart type="family">Gottenberg</namePart><affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gael</namePart><namePart type="family">Cinquetti</namePart><affiliation>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claire</namePart><namePart type="family">Larroche</namePart><affiliation>Service de Médecine interne, CHU Avicenne, Bobigny, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bernard</namePart><namePart type="family">Combe</namePart><affiliation>Service d'Immunorhumathologie, CHU Montpellier, Montpellier, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eric</namePart><namePart type="family">Hachulla</namePart><affiliation>Service de Médecine interne, CHU Lille, Lille, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Olivier</namePart><namePart type="family">Meyer</namePart><affiliation>Service de Rhumatologie, Hôpital Bichat, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Edouard</namePart><namePart type="family">Pertuiset</namePart><affiliation>Service de Rhumatologie, CH Pontoise, Pontoise, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Guy</namePart><namePart type="family">Kaplanski</namePart><affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laurent</namePart><namePart type="family">Chiche</namePart><affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean-Marie</namePart><namePart type="family">Berthelot</namePart><affiliation>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bruno</namePart><namePart type="family">Gombert</namePart><affiliation>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Philippe</namePart><namePart type="family">Goupille</namePart><affiliation>Service de Rhumatologie, CHU Tours, Tours, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christian</namePart><namePart type="family">Marcelli</namePart><affiliation>Service de Rhumatologie, CHU de Caen, Caen, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Séverine</namePart><namePart type="family">Feuillet</namePart><affiliation>Service de Pneumologie, Hôpital Saint Louis, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean</namePart><namePart type="family">Leone</namePart><affiliation>Service de Médecine Interne, Hôpital Debré, Reims, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean</namePart><namePart type="family">Sibilia</namePart><affiliation>Service de Rhumatologie, Centre National de Références des Maladies Auto-Immunes Systémiques Rares, Hôpitaux Universitaires de Strasbourg, Immunorhumathologie Moléculaire, INSERM UMR S 1109, Université de Strasbourg, Strasbourg, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Charles</namePart><namePart type="family">Zarnitsky</namePart><affiliation>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Philippe</namePart><namePart type="family">Carli</namePart><affiliation>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephanie</namePart><namePart type="family">Rist</namePart><affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Philippe</namePart><namePart type="family">Gaudin</namePart><affiliation>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carine</namePart><namePart type="family">Salliot</namePart><affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Muriel</namePart><namePart type="family">Piperno</namePart><affiliation>Service de Rhumatologie, CHU Lyon Sud France,</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adeline</namePart><namePart type="family">Deplas</namePart><affiliation>Service de Rhumatologie, CH Niort, Niort France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maxime</namePart><namePart type="family">Breban</namePart><affiliation>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thierry</namePart><namePart type="family">Lequerre</namePart><affiliation>Service de Rhumatologie, CHU Rouen, Rouen, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pascal</namePart><namePart type="family">Richette</namePart><affiliation>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Charles</namePart><namePart type="family">Ghiringhelli</namePart><affiliation>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mohamed</namePart><namePart type="family">Hamidou</namePart><affiliation>Service de Médecine Interne, CHU de Nantes, Nantes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Philippe</namePart><namePart type="family">Ravaud</namePart><affiliation>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xavier</namePart><namePart type="family">Mariette</namePart><affiliation>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><dateIssued encoding="w3cdtf">2013-06</dateIssued><dateCreated encoding="w3cdtf">2012-12-21</dateCreated><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Objectives To evaluate the efficacy and safety of rituximab in patients with primary Sjögren's syndrome (pSS). Methods The AutoImmune and Rituximab registry has included 86 patients with pSS treated with rituximab, prospectivey followed up every 6 months for 5 years. Results Seventy-eight patients with pSS (11 men, 67 women), who already had at least one follow-up visit, were analysed. Median age was 59.8 years (29–83), median duration of disease was 11.9 years (3–32). Indications for treatment were systemic involvement for 74 patients and only severe glandular involvement in four patients. The median European Sjögren's Syndrome disease activity index (ESSDAI) was 11 (2–31). 17 patients were concomitantly treated with another immunosuppressant agent. Median follow-up was 34.9 months (6–81.4) (226 patient-years). Overall efficacy according to the treating physician was observed in 47 patients (60%) after the first cycle of rituximab. Median ESSDAI decreased from 11 (2–31) to 7.5 (0–26) (p<0.0001). Median dosage of corticosteroid decreased from 17.6 mg/day (3–60) to 10.8 mg/day (p=0.1). Forty-one patients were retreated with rituximab. Four infusion reactions and one delayed serum sickness-like disease resulted in rituximab discontinuation. Three serious infections (1.3/100 patient-years) and two cancer-related deaths occurred. Conclusions In common practice, the use of rituximab in pSS is mostly restricted to patients with systemic involvement. This prospective study shows good efficacy and tolerance of rituximab in patients with pSS and systemic involvement.</abstract><note type="footnotes">J-EG and GC contributed equally to this study.</note><note type="author-notes">Correspondence to Professor Jacques-Eric Gottenberg, ImmunoRhumatologie Moléculaire, Service de Rhumatologie, INSERM UMR_S 1109, Université de Strasbourg, Centre National de Référence des Maladies Auto-Immunes, Hôpital Hautepierre, 1 Avenue Molière, 67000 Strasbourg 67098, France; jacques-eric.gottenberg@chru-strasbourg.fr</note><subject><genre>keywords</genre><topic>Sjøgren's Syndrome</topic><topic>Autoimmunity</topic><topic>Autoimmune Diseases</topic></subject><relatedItem type="host"><titleInfo><title>Annals of the Rheumatic Diseases</title></titleInfo><titleInfo type="abbreviated"><title>Ann Rheum Dis</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0003-4967</identifier><identifier type="eISSN">1468-2060</identifier><identifier type="PublisherID">ard</identifier><identifier type="PublisherID-hwp">annrheumdis</identifier><identifier type="PublisherID-nlm-ta">Ann Rheum Dis</identifier><part><date>2013</date><detail type="volume"><caption>vol.</caption><number>72</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>1026</start></extent></part></relatedItem><identifier type="istex">52A3B80A2058E94C2AC1BECDAEDC9D33451FAAA8</identifier><identifier type="ark">ark:/67375/NVC-RKMXKL43-T</identifier><identifier type="DOI">10.1136/annrheumdis-2012-202293</identifier><identifier type="href">annrheumdis-72-1026.pdf</identifier><identifier type="ArticleID">annrheumdis-2012-202293</identifier><identifier type="PMID">23264337</identifier><identifier type="local">annrheumdis;72/6/1026</identifier><accessCondition type="use and reproduction" contentType="copyright">Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</recordContentSource><recordOrigin>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-RKMXKL43-T/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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