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/Curation ); 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 [France] ; Gael Cinquetti [France] ; Claire Larroche [France] ; Bernard Combe [France] ; Eric Hachulla [France] ; Olivier Meyer [France] ; Edouard Pertuiset [France] ; Guy Kaplanski [France] ; Laurent Chiche [France] ; Jean-Marie Berthelot [France] ; Bruno Gombert [France] ; Philippe Goupille [France] ; Christian Marcelli [France] ; Séverine Feuillet [France] ; Jean Leone [France] ; Jean Sibilia [France] ; Charles Zarnitsky [France] ; Philippe Carli [France] ; Stephanie Rist [France] ; Philippe Gaudin [France] ; Carine Salliot [France] ; Muriel Piperno ; Adeline Deplas [France] ; Maxime Breban [France] ; Thierry Lequerre [France] ; Pascal Richette [France] ; Charles Ghiringhelli [France] ; Mohamed Hamidou [France] ; Philippe Ravaud [France] ; Xavier Mariette [France]Source :
- 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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Muriel Piperno<affiliation><mods:affiliation>Service de Rhumatologie, CHU Lyon Sud France,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation>Le document en format XML
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sortKey="Sibilia, Jean" sort="Sibilia, Jean" uniqKey="Sibilia J" first="Jean" last="Sibilia">Jean Sibilia</name><affiliation wicri:level="1"><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><country xml:lang="fr">France</country><wicri:regionArea>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</wicri:regionArea></affiliation></author><author><name sortKey="Zarnitsky, Charles" sort="Zarnitsky, Charles" uniqKey="Zarnitsky C" first="Charles" last="Zarnitsky">Charles Zarnitsky</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre</wicri:regionArea></affiliation></author><author><name sortKey="Carli, Philippe" sort="Carli, Philippe" uniqKey="Carli P" first="Philippe" last="Carli">Philippe Carli</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, HIA Sainte-Anne, Toulon</wicri:regionArea></affiliation></author><author><name sortKey="Rist, Stephanie" sort="Rist, Stephanie" uniqKey="Rist S" first="Stephanie" last="Rist">Stephanie Rist</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHR Orléans, Orléans</wicri:regionArea></affiliation></author><author><name sortKey="Gaudin, Philippe" sort="Gaudin, Philippe" uniqKey="Gaudin P" first="Philippe" last="Gaudin">Philippe Gaudin</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles</wicri:regionArea></affiliation></author><author><name sortKey="Salliot, Carine" sort="Salliot, Carine" uniqKey="Salliot C" first="Carine" last="Salliot">Carine Salliot</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHR Orléans, Orléans</wicri:regionArea></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><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Deplas, Adeline" sort="Deplas, Adeline" uniqKey="Deplas A" first="Adeline" last="Deplas">Adeline Deplas</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CH Niort, Niort France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CH Niort</wicri:regionArea></affiliation></author><author><name sortKey="Breban, Maxime" sort="Breban, Maxime" uniqKey="Breban M" first="Maxime" last="Breban">Maxime Breban</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt</wicri:regionArea></affiliation></author><author><name sortKey="Lequerre, Thierry" sort="Lequerre, Thierry" uniqKey="Lequerre T" first="Thierry" last="Lequerre">Thierry Lequerre</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Rouen, Rouen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Rouen, Rouen</wicri:regionArea></affiliation></author><author><name sortKey="Richette, Pascal" sort="Richette, Pascal" uniqKey="Richette P" first="Pascal" last="Richette">Pascal Richette</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Hôpital Lariboisière, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Ghiringhelli, Charles" sort="Ghiringhelli, Charles" uniqKey="Ghiringhelli C" first="Charles" last="Ghiringhelli">Charles Ghiringhelli</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, Hôpital Saint André, Bordeaux</wicri:regionArea></affiliation></author><author><name sortKey="Hamidou, Mohamed" sort="Hamidou, Mohamed" uniqKey="Hamidou M" first="Mohamed" last="Hamidou">Mohamed Hamidou</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, CHU de Nantes, Nantes, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, CHU de Nantes, Nantes</wicri:regionArea></affiliation></author><author><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name><affiliation wicri:level="1"><mods:affiliation>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Mariette, Xavier" sort="Mariette, Xavier" uniqKey="Mariette X" first="Xavier" last="Mariette">Xavier Mariette</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris</wicri:regionArea></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><idno type="wicri:Area/Istex/Curation">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 wicri:level="1"><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><country xml:lang="fr">France</country><wicri:regionArea>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</wicri:regionArea></affiliation></author><author><name sortKey="Cinquetti, Gael" sort="Cinquetti, Gael" uniqKey="Cinquetti G" first="Gael" last="Cinquetti">Gael Cinquetti</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne et Maladies Infectieuses, HIA Legouest, Metz</wicri:regionArea></affiliation></author><author><name sortKey="Larroche, Claire" sort="Larroche, Claire" uniqKey="Larroche C" first="Claire" last="Larroche">Claire Larroche</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine interne, CHU Avicenne, Bobigny, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine interne, CHU Avicenne, Bobigny</wicri:regionArea></affiliation></author><author><name sortKey="Combe, Bernard" sort="Combe, Bernard" uniqKey="Combe B" first="Bernard" last="Combe">Bernard Combe</name><affiliation wicri:level="1"><mods:affiliation>Service d'Immunorhumathologie, CHU Montpellier, Montpellier, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service d'Immunorhumathologie, CHU Montpellier, Montpellier</wicri:regionArea></affiliation></author><author><name sortKey="Hachulla, Eric" sort="Hachulla, Eric" uniqKey="Hachulla E" first="Eric" last="Hachulla">Eric Hachulla</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine interne, CHU Lille, Lille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine interne, CHU Lille, Lille</wicri:regionArea></affiliation></author><author><name sortKey="Meyer, Olivier" sort="Meyer, Olivier" uniqKey="Meyer O" first="Olivier" last="Meyer">Olivier Meyer</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Hôpital Bichat, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Hôpital Bichat, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Pertuiset, Edouard" sort="Pertuiset, Edouard" uniqKey="Pertuiset E" first="Edouard" last="Pertuiset">Edouard Pertuiset</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CH Pontoise, Pontoise, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CH Pontoise, Pontoise</wicri:regionArea></affiliation></author><author><name sortKey="Kaplanski, Guy" sort="Kaplanski, Guy" uniqKey="Kaplanski G" first="Guy" last="Kaplanski">Guy Kaplanski</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine interne, Hôpital de la conception, Marseille</wicri:regionArea></affiliation></author><author><name sortKey="Chiche, Laurent" sort="Chiche, Laurent" uniqKey="Chiche L" first="Laurent" last="Chiche">Laurent Chiche</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine interne, Hôpital de la conception, Marseille, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine interne, Hôpital de la conception, Marseille</wicri:regionArea></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 wicri:level="1"><mods:affiliation>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, INSERM U957, CHU Nantes, Nantes</wicri:regionArea></affiliation></author><author><name sortKey="Gombert, Bruno" sort="Gombert, Bruno" uniqKey="Gombert B" first="Bruno" last="Gombert">Bruno Gombert</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Polyvalente - Rhumatologie, CH de La Rochelle, La Rochelle</wicri:regionArea></affiliation></author><author><name sortKey="Goupille, Philippe" sort="Goupille, Philippe" uniqKey="Goupille P" first="Philippe" last="Goupille">Philippe Goupille</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Tours, Tours, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Tours, Tours</wicri:regionArea></affiliation></author><author><name sortKey="Marcelli, Christian" sort="Marcelli, Christian" uniqKey="Marcelli C" first="Christian" last="Marcelli">Christian Marcelli</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU de Caen, Caen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU de Caen, Caen</wicri:regionArea></affiliation></author><author><name sortKey="Feuillet, Severine" sort="Feuillet, Severine" uniqKey="Feuillet S" first="Séverine" last="Feuillet">Séverine Feuillet</name><affiliation wicri:level="1"><mods:affiliation>Service de Pneumologie, Hôpital Saint Louis, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Pneumologie, Hôpital Saint Louis, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Leone, Jean" sort="Leone, Jean" uniqKey="Leone J" first="Jean" last="Leone">Jean Leone</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, Hôpital Debré, Reims, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, Hôpital Debré, Reims</wicri:regionArea></affiliation></author><author><name sortKey="Sibilia, Jean" sort="Sibilia, Jean" uniqKey="Sibilia J" first="Jean" last="Sibilia">Jean Sibilia</name><affiliation wicri:level="1"><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><country xml:lang="fr">France</country><wicri:regionArea>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</wicri:regionArea></affiliation></author><author><name sortKey="Zarnitsky, Charles" sort="Zarnitsky, Charles" uniqKey="Zarnitsky C" first="Charles" last="Zarnitsky">Charles Zarnitsky</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Groupe Hospitalier du Havre, Le Havre</wicri:regionArea></affiliation></author><author><name sortKey="Carli, Philippe" sort="Carli, Philippe" uniqKey="Carli P" first="Philippe" last="Carli">Philippe Carli</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, HIA Sainte-Anne, Toulon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, HIA Sainte-Anne, Toulon</wicri:regionArea></affiliation></author><author><name sortKey="Rist, Stephanie" sort="Rist, Stephanie" uniqKey="Rist S" first="Stephanie" last="Rist">Stephanie Rist</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHR Orléans, Orléans</wicri:regionArea></affiliation></author><author><name sortKey="Gaudin, Philippe" sort="Gaudin, Philippe" uniqKey="Gaudin P" first="Philippe" last="Gaudin">Philippe Gaudin</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Hôpital Sud, Grenoble, Echirolles</wicri:regionArea></affiliation></author><author><name sortKey="Salliot, Carine" sort="Salliot, Carine" uniqKey="Salliot C" first="Carine" last="Salliot">Carine Salliot</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHR Orléans, Orléans, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHR Orléans, Orléans</wicri:regionArea></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><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Deplas, Adeline" sort="Deplas, Adeline" uniqKey="Deplas A" first="Adeline" last="Deplas">Adeline Deplas</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CH Niort, Niort France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CH Niort</wicri:regionArea></affiliation></author><author><name sortKey="Breban, Maxime" sort="Breban, Maxime" uniqKey="Breban M" first="Maxime" last="Breban">Maxime Breban</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Ambroise Paré, Boulogne Billancourt</wicri:regionArea></affiliation></author><author><name sortKey="Lequerre, Thierry" sort="Lequerre, Thierry" uniqKey="Lequerre T" first="Thierry" last="Lequerre">Thierry Lequerre</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, CHU Rouen, Rouen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, CHU Rouen, Rouen</wicri:regionArea></affiliation></author><author><name sortKey="Richette, Pascal" sort="Richette, Pascal" uniqKey="Richette P" first="Pascal" last="Richette">Pascal Richette</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Hôpital Lariboisière, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Hôpital Lariboisière, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Ghiringhelli, Charles" sort="Ghiringhelli, Charles" uniqKey="Ghiringhelli C" first="Charles" last="Ghiringhelli">Charles Ghiringhelli</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, Hôpital Saint André, Bordeaux, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, Hôpital Saint André, Bordeaux</wicri:regionArea></affiliation></author><author><name sortKey="Hamidou, Mohamed" sort="Hamidou, Mohamed" uniqKey="Hamidou M" first="Mohamed" last="Hamidou">Mohamed Hamidou</name><affiliation wicri:level="1"><mods:affiliation>Service de Médecine Interne, CHU de Nantes, Nantes, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Médecine Interne, CHU de Nantes, Nantes</wicri:regionArea></affiliation></author><author><name sortKey="Ravaud, Philippe" sort="Ravaud, Philippe" uniqKey="Ravaud P" first="Philippe" last="Ravaud">Philippe Ravaud</name><affiliation wicri:level="1"><mods:affiliation>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM U738, Département d'Epidémiologie, Biostatistiques et Recherche Clinique, Hôtel Dieu, Centre d'épidémiologie clinique, Paris</wicri:regionArea></affiliation></author><author><name sortKey="Mariette, Xavier" sort="Mariette, Xavier" uniqKey="Mariette X" first="Xavier" last="Mariette">Xavier Mariette</name><affiliation wicri:level="1"><mods:affiliation>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Rhumatologie, Université Paris Sud, AP-HP, Hôpitaux Universitaires Paris Sud, Paris</wicri:regionArea></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></record>Pour manipuler ce document sous Unix (Dilib)
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