Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases
Identifieur interne : 002C22 ( Istex/Corpus ); précédent : 002C21; suivant : 002C23Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases
Auteurs : J-E Gottenberg ; L. Guillevin ; O. Lambotte ; B. Combe ; Y. Allanore ; A. Cantagrel ; C. Larroche ; M. Soubrier ; L. Bouillet ; M. Dougados ; O. Fain ; D. Farge ; X. Kyndt ; O. Lortholary ; C. Masson ; B. Moura ; P. Remy ; T. Thomas ; D. Wendling ; J-M Anaya ; J. Sibilia ; X. MarietteSource :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2005-06.
English descriptors
- KwdEn :
- ACR, American College of Rheumatology, ANCA, antineutrophil cytoplasmic antibodies, DAS28, 28 joint disease activity score, MALT, mucosa associated lymphoid tissue, MC, mixed cryoglobulinaemia, RA, rheumatoid arthritis, SLE, systemic lupus erythematosus, SLEDAI, SLE disease activity index, autoimmunity, pSS, primary Sjögren’s syndrome, primary Sjögren’s syndrome, rituximab, systemic lupus erythematosus, systemic vasculitis.
- Teeft :
- Adverse events, Antisynthetase syndrome, Arthritis, Arthritis rheum, Articular, Autoimmune, Autoimmune disease, Autoimmune diseases, Biological data, Blood neutrophil count, Cell depletion, Clinical involvement, Clinical relapse, Complete remission, Concomitant, Corticosteroid, Cryoglobulinaemia, Cyclophosphamide, Daily rheumatological practice, Disease activity index, Erythematosus, Haemolytic anaemia, Hopital, Hopital cochin, Immunosorbent assay, Immunosuppressant, Infusion, Intravenous immunoglobulin, Joint disease activity score, Lupus, Lymphoma, Marketing authorisation, Medecine, Methotrexate, Mycophenolate mofetil, Nephritis, Partial remission, Present study, Primary syndrome, Refractory, Refractory character, Relapse, Remission, Responder, Retrospective study, Rheum, Rheumatoid, Rheumatoid arthritis, Rheumatoid factor, Rheumatology, Rhumatologie, Rituximab, Rituximab treatment, Sarcoidosis, Serum sickness, Short term efficacy, Sledai, Sledai value, Syndrome, Systemic, Systemic lupus erythematosus, Systemic sclerosis, Vasculitis.
Abstract
Objective: To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice. Methods: 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated. Results: In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögren’s syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the refractory character of the autoimmune disease. The mean follow up period was 8.3 months (range 2 to 26). There were 11 adverse events in 10 patients and treatment had to be discontinued in six. Efficacy was observed in 30 patients (70%): RA 11, SLE 9, pSS 5, vasculitis 2, antisynthetase syndromes 2, sarcoidosis 1. The mean decrease in corticosteroid intake was 9.5 mg/d (range 0 to 50) in responders. Seven patients experienced relapse after mean 8.1 months (5 to 15). Three patients died because of refractory autoimmune disease. Conclusions: Despite absence of marketing authorisation, rituximab is used to treat various refractory autoimmune diseases in daily rheumatological practice. This study showed good tolerance and short term clinical efficacy, with marked corticosteroid reduction in patients with SLE, pSS, vasculitis, and polymyositis.
Url:
DOI: 10.1136/ard.2004.029694
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Kyndt</name><affiliation><mods:affiliation>Service de Nephrologie et Médecine Interne, CHU de Valenciennes, Valenciennes, France</mods:affiliation></affiliation></author><author><name sortKey="Lortholary, O" sort="Lortholary, O" uniqKey="Lortholary O" first="O" last="Lortholary">O. Lortholary</name><affiliation><mods:affiliation>Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris</mods:affiliation></affiliation></author><author><name sortKey="Masson, C" sort="Masson, C" uniqKey="Masson C" first="C" last="Masson">C. Masson</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU d’Angers, Angers, France</mods:affiliation></affiliation></author><author><name sortKey="Moura, B" sort="Moura, B" uniqKey="Moura B" first="B" last="Moura">B. Moura</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne, France</mods:affiliation></affiliation></author><author><name sortKey="Remy, P" sort="Remy, P" uniqKey="Remy P" first="P" last="Remy">P. Remy</name><affiliation><mods:affiliation>Service de Nephrologie, Hôpital Henri Mondor, Créteil, France</mods:affiliation></affiliation></author><author><name sortKey="Thomas, T" sort="Thomas, T" uniqKey="Thomas T" first="T" last="Thomas">T. Thomas</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Saint-Etienne, Saint-Etienne, France</mods:affiliation></affiliation></author><author><name sortKey="Wendling, D" sort="Wendling, D" uniqKey="Wendling D" first="D" last="Wendling">D. Wendling</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Jean Minjoz, Besançon, France</mods:affiliation></affiliation></author><author><name sortKey="Anaya, J M" sort="Anaya, J M" uniqKey="Anaya J" first="J-M" last="Anaya">J-M Anaya</name><affiliation><mods:affiliation>Unidad de Reumatología CIB, Universidad Pontificia Bolivariana, Medellin, Colombia</mods:affiliation></affiliation></author><author><name sortKey="Sibilia, J" sort="Sibilia, J" uniqKey="Sibilia J" first="J" last="Sibilia">J. Sibilia</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Hautepierre, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Mariette, X" sort="Mariette, X" uniqKey="Mariette X" first="X" last="Mariette">X. Mariette</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:377B746FEC990937AFDFC4291C4E6E66A855533F</idno><date when="2005" year="2005">2005</date><idno type="doi">10.1136/ard.2004.029694</idno><idno type="url">https://api.istex.fr/ark:/67375/NVC-QSR0P0HT-P/fulltext.pdf</idno><idno type="wicri:Area/Istex/Corpus">002C22</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002C22</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</title><author><name sortKey="Gottenberg, J E" sort="Gottenberg, J E" uniqKey="Gottenberg J" first="J-E" last="Gottenberg">J-E Gottenberg</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</mods:affiliation></affiliation></author><author><name sortKey="Guillevin, L" sort="Guillevin, L" uniqKey="Guillevin L" first="L" last="Guillevin">L. Guillevin</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Cochin, Paris</mods:affiliation></affiliation></author><author><name sortKey="Lambotte, O" sort="Lambotte, O" uniqKey="Lambotte O" first="O" last="Lambotte">O. Lambotte</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital de Bicêtre</mods:affiliation></affiliation></author><author><name sortKey="Combe, B" sort="Combe, B" uniqKey="Combe B" first="B" last="Combe">B. Combe</name><affiliation><mods:affiliation>Service d’Immuno-Rhumatologie, Hôpital Lapeyronie, Montpellier, France</mods:affiliation></affiliation></author><author><name sortKey="Allanore, Y" sort="Allanore, Y" uniqKey="Allanore Y" first="Y" last="Allanore">Y. Allanore</name><affiliation><mods:affiliation>Service de Rhumatologie A, Hôpital Cochin, Paris</mods:affiliation></affiliation></author><author><name sortKey="Cantagrel, A" sort="Cantagrel, A" uniqKey="Cantagrel A" first="A" last="Cantagrel">A. Cantagrel</name><affiliation><mods:affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire (CHU), Rangueil, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Larroche, C" sort="Larroche, C" uniqKey="Larroche C" first="C" last="Larroche">C. Larroche</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Avicenne, Bobigny, France</mods:affiliation></affiliation></author><author><name sortKey="Soubrier, M" sort="Soubrier, M" uniqKey="Soubrier M" first="M" last="Soubrier">M. Soubrier</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France</mods:affiliation></affiliation></author><author><name sortKey="Bouillet, L" sort="Bouillet, L" uniqKey="Bouillet L" first="L" last="Bouillet">L. Bouillet</name><affiliation><mods:affiliation>Service de Médecine Interne, CHU de Grenoble, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M" last="Dougados">M. Dougados</name><affiliation><mods:affiliation>Service de Rhumatologie B, Hôpital Cochin, Paris</mods:affiliation></affiliation></author><author><name sortKey="Fain, O" sort="Fain, O" uniqKey="Fain O" first="O" last="Fain">O. Fain</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France</mods:affiliation></affiliation></author><author><name sortKey="Farge, D" sort="Farge, D" uniqKey="Farge D" first="D" last="Farge">D. Farge</name><affiliation><mods:affiliation>Service de Médecine Interne, Hôpital Saint-Louis, Paris</mods:affiliation></affiliation></author><author><name sortKey="Kyndt, X" sort="Kyndt, X" uniqKey="Kyndt X" first="X" last="Kyndt">X. Kyndt</name><affiliation><mods:affiliation>Service de Nephrologie et Médecine Interne, CHU de Valenciennes, Valenciennes, France</mods:affiliation></affiliation></author><author><name sortKey="Lortholary, O" sort="Lortholary, O" uniqKey="Lortholary O" first="O" last="Lortholary">O. Lortholary</name><affiliation><mods:affiliation>Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris</mods:affiliation></affiliation></author><author><name sortKey="Masson, C" sort="Masson, C" uniqKey="Masson C" first="C" last="Masson">C. Masson</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU d’Angers, Angers, France</mods:affiliation></affiliation></author><author><name sortKey="Moura, B" sort="Moura, B" uniqKey="Moura B" first="B" last="Moura">B. Moura</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne, France</mods:affiliation></affiliation></author><author><name sortKey="Remy, P" sort="Remy, P" uniqKey="Remy P" first="P" last="Remy">P. Remy</name><affiliation><mods:affiliation>Service de Nephrologie, Hôpital Henri Mondor, Créteil, France</mods:affiliation></affiliation></author><author><name sortKey="Thomas, T" sort="Thomas, T" uniqKey="Thomas T" first="T" last="Thomas">T. Thomas</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Saint-Etienne, Saint-Etienne, France</mods:affiliation></affiliation></author><author><name sortKey="Wendling, D" sort="Wendling, D" uniqKey="Wendling D" first="D" last="Wendling">D. Wendling</name><affiliation><mods:affiliation>Service de Rhumatologie, CHU Jean Minjoz, Besançon, France</mods:affiliation></affiliation></author><author><name sortKey="Anaya, J M" sort="Anaya, J M" uniqKey="Anaya J" first="J-M" last="Anaya">J-M Anaya</name><affiliation><mods:affiliation>Unidad de Reumatología CIB, Universidad Pontificia Bolivariana, Medellin, Colombia</mods:affiliation></affiliation></author><author><name sortKey="Sibilia, J" sort="Sibilia, J" uniqKey="Sibilia J" first="J" last="Sibilia">J. Sibilia</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital Hautepierre, Strasbourg, France</mods:affiliation></affiliation></author><author><name sortKey="Mariette, X" sort="Mariette, X" uniqKey="Mariette X" first="X" last="Mariette">X. Mariette</name><affiliation><mods:affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, 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="2005-06">2005-06</date><biblScope unit="volume">64</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="913">913</biblScope></imprint><idno type="ISSN">0003-4967</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4967</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ACR, American College of Rheumatology</term><term>ANCA, antineutrophil cytoplasmic antibodies</term><term>DAS28, 28 joint disease activity score</term><term>MALT, mucosa associated lymphoid tissue</term><term>MC, mixed cryoglobulinaemia</term><term>RA, rheumatoid arthritis</term><term>SLE, systemic lupus erythematosus</term><term>SLEDAI, SLE disease activity index</term><term>autoimmunity</term><term>pSS, primary Sjögren’s syndrome</term><term>primary Sjögren’s syndrome</term><term>rituximab</term><term>systemic lupus erythematosus</term><term>systemic vasculitis</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Adverse events</term><term>Antisynthetase syndrome</term><term>Arthritis</term><term>Arthritis rheum</term><term>Articular</term><term>Autoimmune</term><term>Autoimmune disease</term><term>Autoimmune diseases</term><term>Biological data</term><term>Blood neutrophil count</term><term>Cell depletion</term><term>Clinical involvement</term><term>Clinical relapse</term><term>Complete remission</term><term>Concomitant</term><term>Corticosteroid</term><term>Cryoglobulinaemia</term><term>Cyclophosphamide</term><term>Daily rheumatological practice</term><term>Disease activity index</term><term>Erythematosus</term><term>Haemolytic anaemia</term><term>Hopital</term><term>Hopital cochin</term><term>Immunosorbent assay</term><term>Immunosuppressant</term><term>Infusion</term><term>Intravenous immunoglobulin</term><term>Joint disease activity score</term><term>Lupus</term><term>Lymphoma</term><term>Marketing authorisation</term><term>Medecine</term><term>Methotrexate</term><term>Mycophenolate mofetil</term><term>Nephritis</term><term>Partial remission</term><term>Present study</term><term>Primary syndrome</term><term>Refractory</term><term>Refractory character</term><term>Relapse</term><term>Remission</term><term>Responder</term><term>Retrospective study</term><term>Rheum</term><term>Rheumatoid</term><term>Rheumatoid arthritis</term><term>Rheumatoid factor</term><term>Rheumatology</term><term>Rhumatologie</term><term>Rituximab</term><term>Rituximab treatment</term><term>Sarcoidosis</term><term>Serum sickness</term><term>Short term efficacy</term><term>Sledai</term><term>Sledai value</term><term>Syndrome</term><term>Systemic</term><term>Systemic lupus erythematosus</term><term>Systemic sclerosis</term><term>Vasculitis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice. Methods: 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated. Results: In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögren’s syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the refractory character of the autoimmune disease. The mean follow up period was 8.3 months (range 2 to 26). There were 11 adverse events in 10 patients and treatment had to be discontinued in six. Efficacy was observed in 30 patients (70%): RA 11, SLE 9, pSS 5, vasculitis 2, antisynthetase syndromes 2, sarcoidosis 1. The mean decrease in corticosteroid intake was 9.5 mg/d (range 0 to 50) in responders. Seven patients experienced relapse after mean 8.1 months (5 to 15). Three patients died because of refractory autoimmune disease. Conclusions: Despite absence of marketing authorisation, rituximab is used to treat various refractory autoimmune diseases in daily rheumatological practice. This study showed good tolerance and short term clinical efficacy, with marked corticosteroid reduction in patients with SLE, pSS, vasculitis, and polymyositis.</div></front></TEI><istex><corpusName>bmj</corpusName><keywords><teeft><json:string>rituximab</json:string><json:string>autoimmune</json:string><json:string>vasculitis</json:string><json:string>relapse</json:string><json:string>cryoglobulinaemia</json:string><json:string>rheumatoid</json:string><json:string>lupus</json:string><json:string>hopital</json:string><json:string>remission</json:string><json:string>cyclophosphamide</json:string><json:string>rhumatologie</json:string><json:string>autoimmune diseases</json:string><json:string>infusion</json:string><json:string>methotrexate</json:string><json:string>responder</json:string><json:string>nephritis</json:string><json:string>sledai</json:string><json:string>corticosteroid</json:string><json:string>erythematosus</json:string><json:string>articular</json:string><json:string>immunosuppressant</json:string><json:string>systemic lupus erythematosus</json:string><json:string>rituximab treatment</json:string><json:string>rheumatology</json:string><json:string>autoimmune disease</json:string><json:string>concomitant</json:string><json:string>sarcoidosis</json:string><json:string>partial remission</json:string><json:string>rheumatoid arthritis</json:string><json:string>lymphoma</json:string><json:string>complete remission</json:string><json:string>refractory</json:string><json:string>serum sickness</json:string><json:string>biological data</json:string><json:string>syndrome</json:string><json:string>rheum</json:string><json:string>refractory character</json:string><json:string>mycophenolate mofetil</json:string><json:string>sledai value</json:string><json:string>marketing authorisation</json:string><json:string>rheumatoid factor</json:string><json:string>present study</json:string><json:string>antisynthetase syndrome</json:string><json:string>arthritis rheum</json:string><json:string>medecine</json:string><json:string>clinical relapse</json:string><json:string>disease activity index</json:string><json:string>joint disease activity score</json:string><json:string>adverse events</json:string><json:string>haemolytic anaemia</json:string><json:string>primary syndrome</json:string><json:string>immunosorbent assay</json:string><json:string>intravenous immunoglobulin</json:string><json:string>systemic sclerosis</json:string><json:string>clinical involvement</json:string><json:string>daily rheumatological practice</json:string><json:string>blood neutrophil count</json:string><json:string>cell depletion</json:string><json:string>retrospective study</json:string><json:string>hopital cochin</json:string><json:string>short term efficacy</json:string><json:string>systemic</json:string><json:string>arthritis</json:string></teeft></keywords><author><json:item><name>J-E Gottenberg</name><affiliations><json:string>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</json:string></affiliations></json:item><json:item><name>L Guillevin</name><affiliations><json:string>Service de Médecine Interne, Hôpital Cochin, Paris</json:string></affiliations></json:item><json:item><name>O Lambotte</name><affiliations><json:string>Service de Médecine Interne, Hôpital de Bicêtre</json:string></affiliations></json:item><json:item><name>B Combe</name><affiliations><json:string>Service d’Immuno-Rhumatologie, Hôpital Lapeyronie, Montpellier, France</json:string></affiliations></json:item><json:item><name>Y Allanore</name><affiliations><json:string>Service de Rhumatologie A, Hôpital Cochin, Paris</json:string></affiliations></json:item><json:item><name>A Cantagrel</name><affiliations><json:string>Service de Rhumatologie, Centre Hospitalier Universitaire (CHU), Rangueil, Toulouse, France</json:string></affiliations></json:item><json:item><name>C Larroche</name><affiliations><json:string>Service de Médecine Interne, Hôpital Avicenne, Bobigny, France</json:string></affiliations></json:item><json:item><name>M Soubrier</name><affiliations><json:string>Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France</json:string></affiliations></json:item><json:item><name>L Bouillet</name><affiliations><json:string>Service de Médecine Interne, CHU de Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>M Dougados</name><affiliations><json:string>Service de Rhumatologie B, Hôpital Cochin, Paris</json:string></affiliations></json:item><json:item><name>O Fain</name><affiliations><json:string>Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France</json:string></affiliations></json:item><json:item><name>D Farge</name><affiliations><json:string>Service de Médecine Interne, Hôpital Saint-Louis, Paris</json:string></affiliations></json:item><json:item><name>X Kyndt</name><affiliations><json:string>Service de Nephrologie et Médecine Interne, CHU de Valenciennes, Valenciennes, France</json:string></affiliations></json:item><json:item><name>O Lortholary</name><affiliations><json:string>Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris</json:string></affiliations></json:item><json:item><name>C Masson</name><affiliations><json:string>Service de Rhumatologie, CHU d’Angers, Angers, France</json:string></affiliations></json:item><json:item><name>B Moura</name><affiliations><json:string>Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne, France</json:string></affiliations></json:item><json:item><name>P Remy</name><affiliations><json:string>Service de Nephrologie, Hôpital Henri Mondor, Créteil, France</json:string></affiliations></json:item><json:item><name>T Thomas</name><affiliations><json:string>Service de Rhumatologie, CHU Saint-Etienne, Saint-Etienne, France</json:string></affiliations></json:item><json:item><name>D Wendling</name><affiliations><json:string>Service de Rhumatologie, CHU Jean Minjoz, Besançon, France</json:string></affiliations></json:item><json:item><name>J-M Anaya</name><affiliations><json:string>Unidad de Reumatología CIB, Universidad Pontificia Bolivariana, Medellin, Colombia</json:string></affiliations></json:item><json:item><name>J Sibilia</name><affiliations><json:string>Service de Rhumatologie, Hôpital Hautepierre, Strasbourg, France</json:string></affiliations></json:item><json:item><name>X Mariette</name><affiliations><json:string>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>ACR, American College of Rheumatology</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ANCA, antineutrophil cytoplasmic antibodies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>DAS28, 28 joint disease activity score</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MALT, mucosa associated lymphoid tissue</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MC, mixed cryoglobulinaemia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>pSS, primary Sjögren’s syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>RA, rheumatoid arthritis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SLE, systemic lupus erythematosus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>SLEDAI, SLE disease activity index</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>primary Sjögren’s syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>systemic lupus erythematosus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>systemic vasculitis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rituximab</value></json:item></subject><arkIstex>ark:/67375/NVC-QSR0P0HT-P</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>other</json:string></originalGenre><abstract>Objective: To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice. Methods: 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated. Results: In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögren’s syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the refractory character of the autoimmune disease. The mean follow up period was 8.3 months (range 2 to 26). There were 11 adverse events in 10 patients and treatment had to be discontinued in six. Efficacy was observed in 30 patients (70%): RA 11, SLE 9, pSS 5, vasculitis 2, antisynthetase syndromes 2, sarcoidosis 1. The mean decrease in corticosteroid intake was 9.5 mg/d (range 0 to 50) in responders. Seven patients experienced relapse after mean 8.1 months (5 to 15). Three patients died because of refractory autoimmune disease. Conclusions: Despite absence of marketing authorisation, rituximab is used to treat various refractory autoimmune diseases in daily rheumatological practice. This study showed good tolerance and short term clinical efficacy, with marked corticosteroid reduction in patients with SLE, pSS, vasculitis, and polymyositis.</abstract><qualityIndicators><score>9.721</score><pdfWordCount>4721</pdfWordCount><pdfCharCount>35047</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>8</pdfPageCount><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>251</abstractWordCount><abstractCharCount>1666</abstractCharCount><keywordCount>14</keywordCount></qualityIndicators><title>Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</title><pmid><json:string>15550531</json:string></pmid><genre><json:string>other</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><volume>64</volume><issue>6</issue><pages><first>913</first></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Immunology (including allergy)</value></json:item><json:item><value>Muscle disease</value></json:item><json:item><value>Connective tissue disease</value></json:item><json:item><value>Degenerative joint disease</value></json:item><json:item><value>Musculoskeletal syndromes</value></json:item><json:item><value>Rheumatoid arthritis</value></json:item><json:item><value>Systemic lupus erythematosus</value></json:item><json:item><value>Vascularitis</value></json:item></subject></host><namedEntities><unitex><date><json:string>2004-11-18</json:string></date><geogName></geogName><orgName><json:string>American College of Rheumatology</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Ambroise Pare</json:string><json:string>CHU Saint-Etienne</json:string><json:string>Jean Verdier</json:string><json:string>Matthieu Tamby</json:string><json:string>CHU Jean</json:string><json:string>Christophe Richez</json:string><json:string>Arielle Rosenberg</json:string><json:string>Xavier Mariette</json:string><json:string>Henri Mondor</json:string><json:string>Stephanie Poulain</json:string><json:string>AZA Vasculitis</json:string><json:string>Universitaire</json:string><json:string>CHU Gabriel</json:string></persName><placeName><json:string>Saint-Etienne</json:string><json:string>Montpellier</json:string><json:string>Grenoble</json:string><json:string>Valenciennes</json:string><json:string>Clermont-Ferrand</json:string><json:string>Strasbourg</json:string><json:string>Toulouse</json:string><json:string>Angers</json:string><json:string>France</json:string></placeName><ref_url></ref_url><ref_bibl></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-QSR0P0HT-P</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><json:string>4 - informatique, statistique et modelisations biomedicales</json:string></inist></categories><publicationDate>2005</publicationDate><copyrightDate>2005</copyrightDate><doi><json:string>10.1136/ard.2004.029694</json:string></doi><id>377B746FEC990937AFDFC4291C4E6E66A855533F</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-QSR0P0HT-P/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-QSR0P0HT-P/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/NVC-QSR0P0HT-P/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</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>Copyright 2005 by Annals of the Rheumatic Diseases</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2004-11-18</date></publicationStmt><notesStmt><note type="other" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-7474895G-0">other</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note><note>Correspondence to:
Professor Xavier Mariette
Service de Rhumatologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France; xavier.mariette@bct.ap-hop-paris.fr</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</title><author xml:id="author-0000"><persName><forename type="first">J-E</forename><surname>Gottenberg</surname></persName><affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</affiliation></author><author xml:id="author-0001"><persName><forename type="first">L</forename><surname>Guillevin</surname></persName><affiliation>Service de Médecine Interne, Hôpital Cochin, Paris</affiliation></author><author xml:id="author-0002"><persName><forename type="first">O</forename><surname>Lambotte</surname></persName><affiliation>Service de Médecine Interne, Hôpital de Bicêtre</affiliation></author><author xml:id="author-0003"><persName><forename type="first">B</forename><surname>Combe</surname></persName><affiliation>Service d’Immuno-Rhumatologie, Hôpital Lapeyronie, Montpellier, France</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Y</forename><surname>Allanore</surname></persName><affiliation>Service de Rhumatologie A, Hôpital Cochin, Paris</affiliation></author><author xml:id="author-0005"><persName><forename type="first">A</forename><surname>Cantagrel</surname></persName><affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire (CHU), Rangueil, Toulouse, France</affiliation></author><author xml:id="author-0006"><persName><forename type="first">C</forename><surname>Larroche</surname></persName><affiliation>Service de Médecine Interne, Hôpital Avicenne, Bobigny, France</affiliation></author><author xml:id="author-0007"><persName><forename type="first">M</forename><surname>Soubrier</surname></persName><affiliation>Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France</affiliation></author><author xml:id="author-0008"><persName><forename type="first">L</forename><surname>Bouillet</surname></persName><affiliation>Service de Médecine Interne, CHU de Grenoble, Grenoble, France</affiliation></author><author xml:id="author-0009"><persName><forename type="first">M</forename><surname>Dougados</surname></persName><affiliation>Service de Rhumatologie B, Hôpital Cochin, Paris</affiliation></author><author xml:id="author-0010"><persName><forename type="first">O</forename><surname>Fain</surname></persName><affiliation>Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France</affiliation></author><author xml:id="author-0011"><persName><forename type="first">D</forename><surname>Farge</surname></persName><affiliation>Service de Médecine Interne, Hôpital Saint-Louis, Paris</affiliation></author><author xml:id="author-0012"><persName><forename type="first">X</forename><surname>Kyndt</surname></persName><affiliation>Service de Nephrologie et Médecine Interne, CHU de Valenciennes, Valenciennes, France</affiliation></author><author xml:id="author-0013"><persName><forename type="first">O</forename><surname>Lortholary</surname></persName><affiliation>Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris</affiliation></author><author xml:id="author-0014"><persName><forename type="first">C</forename><surname>Masson</surname></persName><affiliation>Service de Rhumatologie, CHU d’Angers, Angers, France</affiliation></author><author xml:id="author-0015"><persName><forename type="first">B</forename><surname>Moura</surname></persName><affiliation>Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne, France</affiliation></author><author xml:id="author-0016"><persName><forename type="first">P</forename><surname>Remy</surname></persName><affiliation>Service de Nephrologie, Hôpital Henri Mondor, Créteil, France</affiliation></author><author xml:id="author-0017"><persName><forename type="first">T</forename><surname>Thomas</surname></persName><affiliation>Service de Rhumatologie, CHU Saint-Etienne, Saint-Etienne, France</affiliation></author><author xml:id="author-0018"><persName><forename type="first">D</forename><surname>Wendling</surname></persName><affiliation>Service de Rhumatologie, CHU Jean Minjoz, Besançon, France</affiliation></author><author xml:id="author-0019"><persName><forename type="first">J-M</forename><surname>Anaya</surname></persName><affiliation>Unidad de Reumatología CIB, Universidad Pontificia Bolivariana, Medellin, Colombia</affiliation></author><author xml:id="author-0020"><persName><forename type="first">J</forename><surname>Sibilia</surname></persName><affiliation>Service de Rhumatologie, Hôpital Hautepierre, Strasbourg, France</affiliation></author><author xml:id="author-0021"><persName><forename type="first">X</forename><surname>Mariette</surname></persName><affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</affiliation></author><idno type="istex">377B746FEC990937AFDFC4291C4E6E66A855533F</idno><idno type="ark">ark:/67375/NVC-QSR0P0HT-P</idno><idno type="DOI">10.1136/ard.2004.029694</idno><idno type="href">annrheumdis-64-913.pdf</idno><idno type="PMID">15550531</idno><idno type="local">0640913</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="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="2005-06"></date><biblScope unit="volume">64</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="913">913</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2004-11-18</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective: To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice. Methods: 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated. Results: In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögren’s syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the refractory character of the autoimmune disease. The mean follow up period was 8.3 months (range 2 to 26). There were 11 adverse events in 10 patients and treatment had to be discontinued in six. Efficacy was observed in 30 patients (70%): RA 11, SLE 9, pSS 5, vasculitis 2, antisynthetase syndromes 2, sarcoidosis 1. The mean decrease in corticosteroid intake was 9.5 mg/d (range 0 to 50) in responders. Seven patients experienced relapse after mean 8.1 months (5 to 15). Three patients died because of refractory autoimmune disease. Conclusions: Despite absence of marketing authorisation, rituximab is used to treat various refractory autoimmune diseases in daily rheumatological practice. This study showed good tolerance and short term clinical efficacy, with marked corticosteroid reduction in patients with SLE, pSS, vasculitis, and polymyositis.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>ABR</head><item><term>ACR, American College of Rheumatology</term></item><item><term>ANCA, antineutrophil cytoplasmic antibodies</term></item><item><term>DAS28, 28 joint disease activity score</term></item><item><term>MALT, mucosa associated lymphoid tissue</term></item><item><term>MC, mixed cryoglobulinaemia</term></item><item><term>pSS, primary Sjögren’s syndrome</term></item><item><term>RA, rheumatoid arthritis</term></item><item><term>SLE, systemic lupus erythematosus</term></item><item><term>SLEDAI, SLE disease activity index</term></item></list></keywords></textClass><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>autoimmunity</term></item><item><term>primary Sjögren’s syndrome</term></item><item><term>systemic lupus erythematosus</term></item><item><term>systemic vasculitis</term></item><item><term>rituximab</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Immunology (including allergy)</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Muscle disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Connective tissue disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Degenerative joint disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Musculoskeletal syndromes</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Rheumatoid arthritis</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Systemic lupus erythematosus</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>hwp-journal-coll</head><item><term>Vascularitis</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2004-11-18">Created</change><change when="2005-06">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-QSR0P0HT-P/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" 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pub-id-type="other">annrheumdis;ard.2004.029694</article-id><article-id pub-id-type="pmid">15550531</article-id><article-id pub-id-type="other">913</article-id><article-id pub-id-type="other">ard.2004.029694</article-id><article-categories><subj-group subj-group-type="heading"><subject content-type="original">Extended reports</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Immunology (including allergy)</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Muscle disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Connective tissue disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Degenerative joint disease</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Musculoskeletal syndromes</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Rheumatoid arthritis</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Systemic lupus erythematosus</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>Vascularitis</subject></subj-group></article-categories><title-group><article-title>Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Gottenberg</surname><given-names>J-E</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Guillevin</surname><given-names>L</given-names></name><xref rid="AFF3">3</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lambotte</surname><given-names>O</given-names></name><xref rid="AFF2">2</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Combe</surname><given-names>B</given-names></name><xref rid="AFF4">4</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Allanore</surname><given-names>Y</given-names></name><xref rid="AFF5">5</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Cantagrel</surname><given-names>A</given-names></name><xref rid="AFF6">6</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Larroche</surname><given-names>C</given-names></name><xref rid="AFF7">7</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Soubrier</surname><given-names>M</given-names></name><xref rid="AFF8">8</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Bouillet</surname><given-names>L</given-names></name><xref rid="AFF9">9</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Dougados</surname><given-names>M</given-names></name><xref rid="AFF10">10</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Fain</surname><given-names>O</given-names></name><xref rid="AFF11">11</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Farge</surname><given-names>D</given-names></name><xref rid="AFF12">12</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Kyndt</surname><given-names>X</given-names></name><xref rid="AFF13">13</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lortholary</surname><given-names>O</given-names></name><xref rid="AFF14">14</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Masson</surname><given-names>C</given-names></name><xref rid="AFF15">15</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Moura</surname><given-names>B</given-names></name><xref rid="AFF16">16</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Remy</surname><given-names>P</given-names></name><xref rid="AFF17">17</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Thomas</surname><given-names>T</given-names></name><xref rid="AFF18">18</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Wendling</surname><given-names>D</given-names></name><xref rid="AFF19">19</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Anaya</surname><given-names>J-M</given-names></name><xref rid="AFF20">20</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Sibilia</surname><given-names>J</given-names></name><xref rid="AFF21">21</xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Mariette</surname><given-names>X</given-names></name><xref rid="AFF1">1</xref></contrib><contrib contrib-type="group-author" xlink:type="simple"><on-behalf-of>for the Club Rhumatismes et Inflammation (CRI)</on-behalf-of></contrib><aff id="AFF1"><label>1</label>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</aff><aff id="AFF2"><label>2</label>Service de Médecine Interne, Hôpital de Bicêtre</aff><aff id="AFF3"><label>3</label>Service de Médecine Interne, Hôpital Cochin, Paris</aff><aff id="AFF4"><label>4</label>Service d’Immuno-Rhumatologie, Hôpital Lapeyronie, Montpellier, France</aff><aff id="AFF5"><label>5</label>Service de Rhumatologie A, Hôpital Cochin, Paris</aff><aff id="AFF6"><label>6</label>Service de Rhumatologie, Centre Hospitalier Universitaire (CHU), Rangueil, Toulouse, France</aff><aff id="AFF7"><label>7</label>Service de Médecine Interne, Hôpital Avicenne, Bobigny, France</aff><aff id="AFF8"><label>8</label>Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France</aff><aff id="AFF9"><label>9</label>Service de Médecine Interne, CHU de Grenoble, Grenoble, France</aff><aff id="AFF10"><label>10</label>Service de Rhumatologie B, Hôpital Cochin, Paris</aff><aff id="AFF11"><label>11</label>Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France</aff><aff id="AFF12"><label>12</label>Service de Médecine Interne, Hôpital Saint-Louis, Paris</aff><aff id="AFF13"><label>13</label>Service de Nephrologie et Médecine Interne, CHU de Valenciennes, Valenciennes, France</aff><aff id="AFF14"><label>14</label>Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris</aff><aff id="AFF15"><label>15</label>Service de Rhumatologie, CHU d’Angers, Angers, France</aff><aff id="AFF16"><label>16</label>Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne, France</aff><aff id="AFF17"><label>17</label>Service de Nephrologie, Hôpital Henri Mondor, Créteil, France</aff><aff id="AFF18"><label>18</label>Service de Rhumatologie, CHU Saint-Etienne, Saint-Etienne, France</aff><aff id="AFF19"><label>19</label>Service de Rhumatologie, CHU Jean Minjoz, Besançon, France</aff><aff id="AFF20"><label>20</label>Unidad de Reumatología CIB, Universidad Pontificia Bolivariana, Medellin, Colombia</aff><aff id="AFF21"><label>21</label>Service de Rhumatologie, Hôpital Hautepierre, Strasbourg, France</aff></contrib-group><author-notes><corresp>Correspondence to:
Professor Xavier Mariette
Service de Rhumatologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France; <ext-link xlink:href="xavier.mariettebct.ap-hop-paris.fr" ext-link-type="email" xlink:type="simple">xavier.mariette@bct.ap-hop-paris.fr</ext-link></corresp></author-notes><pub-date pub-type="ppub"><month>6</month><year>2005</year></pub-date><pub-date pub-type="epub"><day>18</day><month>11</month><year>2004</year></pub-date><volume>64</volume><volume-id pub-id-type="other">64</volume-id><volume-id pub-id-type="other">64</volume-id><issue>6</issue><issue-id pub-id-type="other">annrheumdis;64/6</issue-id><issue-id pub-id-type="other">6</issue-id><issue-id pub-id-type="other">64/6</issue-id><fpage>913</fpage><history><date date-type="accepted"><day>09</day><month>11</month><year>2004</year></date></history><permissions><copyright-statement>Copyright 2005 by Annals of the Rheumatic Diseases</copyright-statement><copyright-year>2005</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="annrheumdis-64-913.pdf"></self-uri><abstract xml:lang="en"><p><bold>Objective:</bold> To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice.</p><p><bold>Methods:</bold> 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated.</p><p><bold>Results:</bold> In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögren’s syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the refractory character of the autoimmune disease. The mean follow up period was 8.3 months (range 2 to 26). There were 11 adverse events in 10 patients and treatment had to be discontinued in six. Efficacy was observed in 30 patients (70%): RA 11, SLE 9, pSS 5, vasculitis 2, antisynthetase syndromes 2, sarcoidosis 1. The mean decrease in corticosteroid intake was 9.5 mg/d (range 0 to 50) in responders. Seven patients experienced relapse after mean 8.1 months (5 to 15). Three patients died because of refractory autoimmune disease.</p><p><bold>Conclusions:</bold> Despite absence of marketing authorisation, rituximab is used to treat various refractory autoimmune diseases in daily rheumatological practice. This study showed good tolerance and short term clinical efficacy, with marked corticosteroid reduction in patients with SLE, pSS, vasculitis, and polymyositis.</p></abstract><kwd-group kwd-group-type="ABR" xml:lang="en"><kwd>ACR, American College of Rheumatology</kwd><kwd>ANCA, antineutrophil cytoplasmic antibodies</kwd><kwd>DAS28, 28 joint disease activity score</kwd><kwd>MALT, mucosa associated lymphoid tissue</kwd><kwd>MC, mixed cryoglobulinaemia</kwd><kwd>pSS, primary Sjögren’s syndrome</kwd><kwd>RA, rheumatoid arthritis</kwd><kwd>SLE, systemic lupus erythematosus</kwd><kwd>SLEDAI, SLE disease activity index</kwd></kwd-group><kwd-group kwd-group-type="KWD" xml:lang="en"><kwd>autoimmunity</kwd><kwd>primary Sjögren’s syndrome</kwd><kwd>systemic lupus erythematosus</kwd><kwd>systemic vasculitis</kwd><kwd>rituximab</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Tolerance and short term efficacy of rituximab in 43 patients with systemic autoimmune diseases</title></titleInfo><name type="personal"><namePart type="given">J-E</namePart><namePart type="family">Gottenberg</namePart><affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L</namePart><namePart type="family">Guillevin</namePart><affiliation>Service de Médecine Interne, Hôpital Cochin, Paris</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O</namePart><namePart type="family">Lambotte</namePart><affiliation>Service de Médecine Interne, Hôpital de Bicêtre</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B</namePart><namePart type="family">Combe</namePart><affiliation>Service d’Immuno-Rhumatologie, Hôpital Lapeyronie, Montpellier, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Y</namePart><namePart type="family">Allanore</namePart><affiliation>Service de Rhumatologie A, Hôpital Cochin, Paris</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A</namePart><namePart type="family">Cantagrel</namePart><affiliation>Service de Rhumatologie, Centre Hospitalier Universitaire (CHU), Rangueil, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Larroche</namePart><affiliation>Service de Médecine Interne, Hôpital Avicenne, Bobigny, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Soubrier</namePart><affiliation>Service de Rhumatologie, CHU Gabriel Montpied, Clermont-Ferrand, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L</namePart><namePart type="family">Bouillet</namePart><affiliation>Service de Médecine Interne, CHU de Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">M</namePart><namePart type="family">Dougados</namePart><affiliation>Service de Rhumatologie B, Hôpital Cochin, Paris</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O</namePart><namePart type="family">Fain</namePart><affiliation>Service de Médecine Interne, Hôpital Jean Verdier, Bondy, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D</namePart><namePart type="family">Farge</namePart><affiliation>Service de Médecine Interne, Hôpital Saint-Louis, Paris</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">X</namePart><namePart type="family">Kyndt</namePart><affiliation>Service de Nephrologie et Médecine Interne, CHU de Valenciennes, Valenciennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">O</namePart><namePart type="family">Lortholary</namePart><affiliation>Service de Maladies Infectieuses et Tropicales, Hôpital Necker-Enfants Malades, Paris</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C</namePart><namePart type="family">Masson</namePart><affiliation>Service de Rhumatologie, CHU d’Angers, Angers, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B</namePart><namePart type="family">Moura</namePart><affiliation>Service de Rhumatologie, Hôpital Ambroise Paré, Boulogne, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P</namePart><namePart type="family">Remy</namePart><affiliation>Service de Nephrologie, Hôpital Henri Mondor, Créteil, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T</namePart><namePart type="family">Thomas</namePart><affiliation>Service de Rhumatologie, CHU Saint-Etienne, Saint-Etienne, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D</namePart><namePart type="family">Wendling</namePart><affiliation>Service de Rhumatologie, CHU Jean Minjoz, Besançon, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J-M</namePart><namePart type="family">Anaya</namePart><affiliation>Unidad de Reumatología CIB, Universidad Pontificia Bolivariana, Medellin, Colombia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J</namePart><namePart type="family">Sibilia</namePart><affiliation>Service de Rhumatologie, Hôpital Hautepierre, Strasbourg, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">X</namePart><namePart type="family">Mariette</namePart><affiliation>Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="other" displayLabel="other" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-7474895G-0">other</genre><originInfo><publisher>BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><dateIssued encoding="w3cdtf">2005-06</dateIssued><dateCreated encoding="w3cdtf">2004-11-18</dateCreated><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract lang="en">Objective: To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice. Methods: 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated. Results: In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögren’s syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the refractory character of the autoimmune disease. The mean follow up period was 8.3 months (range 2 to 26). There were 11 adverse events in 10 patients and treatment had to be discontinued in six. Efficacy was observed in 30 patients (70%): RA 11, SLE 9, pSS 5, vasculitis 2, antisynthetase syndromes 2, sarcoidosis 1. The mean decrease in corticosteroid intake was 9.5 mg/d (range 0 to 50) in responders. Seven patients experienced relapse after mean 8.1 months (5 to 15). Three patients died because of refractory autoimmune disease. Conclusions: Despite absence of marketing authorisation, rituximab is used to treat various refractory autoimmune diseases in daily rheumatological practice. This study showed good tolerance and short term clinical efficacy, with marked corticosteroid reduction in patients with SLE, pSS, vasculitis, and polymyositis.</abstract><note type="author-notes">Correspondence to:
Professor Xavier Mariette
Service de Rhumatologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France; xavier.mariette@bct.ap-hop-paris.fr</note><subject lang="en"><genre>ABR</genre><topic>ACR, American College of Rheumatology</topic><topic>ANCA, antineutrophil cytoplasmic antibodies</topic><topic>DAS28, 28 joint disease activity score</topic><topic>MALT, mucosa associated lymphoid tissue</topic><topic>MC, mixed cryoglobulinaemia</topic><topic>pSS, primary Sjögren’s syndrome</topic><topic>RA, rheumatoid arthritis</topic><topic>SLE, systemic lupus erythematosus</topic><topic>SLEDAI, SLE disease activity index</topic></subject><subject lang="en"><genre>KWD</genre><topic>autoimmunity</topic><topic>primary Sjögren’s syndrome</topic><topic>systemic lupus erythematosus</topic><topic>systemic vasculitis</topic><topic>rituximab</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><subject><genre>hwp-journal-coll</genre><topic>Immunology (including allergy)</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Muscle disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Connective tissue disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Degenerative joint disease</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Musculoskeletal syndromes</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Rheumatoid arthritis</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Systemic lupus erythematosus</topic></subject><subject><genre>hwp-journal-coll</genre><topic>Vascularitis</topic></subject><identifier type="ISSN">0003-4967</identifier><identifier type="eISSN">1468-2060</identifier><identifier type="PublisherID-hwp">annrheumdis</identifier><identifier type="PublisherID-nlm-ta">Ann Rheum Dis</identifier><part><date>2005</date><detail type="volume"><caption>vol.</caption><number>64</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>913</start></extent></part></relatedItem><identifier type="istex">377B746FEC990937AFDFC4291C4E6E66A855533F</identifier><identifier type="ark">ark:/67375/NVC-QSR0P0HT-P</identifier><identifier type="DOI">10.1136/ard.2004.029694</identifier><identifier type="href">annrheumdis-64-913.pdf</identifier><identifier type="PMID">15550531</identifier><identifier type="local">0640913</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright 2005 by Annals of the Rheumatic Diseases</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>Copyright 2005 by Annals of the Rheumatic Diseases</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-QSR0P0HT-P/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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