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Vol. 11. Issue 3.
Pages 165-169 (May - June 2015)
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Vol. 11. Issue 3.
Pages 165-169 (May - June 2015)
Review Article
DOI: 10.1016/j.reumae.2015.01.004
Rituximab in the Treatment of Eosinophilic Granulomatosis With Polyangiitis
Rituximab en el tratamiento de la granulomatosis eosinofílica con poliangitis
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Sebastián Andrés Muñoza,
Corresponding author
, Ignacio Javier Gandinoa, Alberto Omar Ordenb, Alberto Allievic
a Servicio de Clínica Médica División «A», Hospital General de Agudos Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina
b Servicio de Reumatología, Hospital Aeronáutico Central, Ciudad Autónoma de Buenos Aires, Argentina
c Exjefe del Servicio de Clínica Médica División «A», Hospital General de Agudos Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina
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Tables (3)
Table 1. General Characteristics of the 27 EGPA Patients Treated With RTX Until February 2014.
Table 2. Details of the Presence of ANCA, Eosinophils and Lymphocytes CD20+ Before and After Treatment With RTX.
Table 3. Details of Response to Treatment With RTX in EGPA Cases Analyzed and 2 Recent Series Reported in Abstracts.
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Abstract
Background

The general consensus is that for patients with EGPA with poor prognosis, intensive therapy with both GC and CF is indicated. The maintenance of remission is made with GC and AZA. A considerable number of patients with EGPA are refractory to first line therapy, experience dose-limiting side effects or relapse. In clinical trials, RTX was effective for the treatment of ANCA-associated vasculitis. However, patients with a diagnosis of EGPA were not included.

Objective

To review and analyze the published literature regarding the use of RTX in the treatment of EGPA.

Methods

The literature search was performed in MEDLINE and LILACS from 1965 and 1986 respectively until February 2014.

Results

27 patients were included. RTX treatment was due to refractory disease (n=20), relapse (n=5) and with new diagnosis (n=2). The affected organs were the lungs, peripheral nervous system, kidney and the eyes. Sixteen patients had clinical remission and 8 patients had clinical response.

Conclusions

RTX was effective and well tolerated for the treatment of EGPA.

Keywords:
Rituximab
Eosinophilic granulomatosis with polyangiitis
Antineutrophil cytoplasmic antibodies associated vasculitis
Resumen
Antecedentes

Algunos pacientes con granulomatosis eosinofílica con poliangitis (EGPA) y factores de mal pronóstico son refractarios o presentan efectos adversos al tratamiento de inducción (glucocorticoides [GC] y ciclofosfamida [CF]), o recaen durante el mantenimiento (GC y azatioprina), haciendo necesaria la búsqueda de alternativas terapéuticas. En ensayos clínicos, el RTX demostró ser eficaz para el tratamiento de las vasculitis asociadas al ANCA; sin embargo, los pacientes con EGPA no fueron incluidos.

Objetivo

Revisar y analizar la bibliografía sobre la uso de RTX para el tratamiento de la EGPA.

Métodos

La búsqueda se realizó en MEDLINE y LILACS (1965 y 1986, respectivamente, hasta febrero del 2014).

Resultados

Se incluyó a 27 pacientes. La indicación de RTX fue por enfermedad refractaria (n=20), recaída (n=5) y nuevo diagnóstico (n=2). Los órganos afectados fueron los pulmones, el sistema nervioso periférico, el riñón y los ojos. Se observó remisión en 16 y respuesta en 8 pacientes.

Conclusiones

El RTX fue eficaz y bien tolerado para el tratamiento de la EGPA.

Palabras clave:
Rituximab
Granulomatosis eosinofílica con poliangitis
Vasculitis asociadas a anticuerpos anticitoplasma de neutrófilo

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