Rituximab treatment for IgA vasculitis: A systematic review.


BACKGROUND:Immunoglobulin A vasculitis (IgAV) is a systemic small vessel vasculitis for which treatment of severe cases is usually based on glucocorticoids and other conventional immunosuppressive drugs. The role of rituximab for resistant or refractory cases has been explored in isolated case reports and small series. AIMS:To perform a literature review of all pediatric and adult patients with IgAV treated with rituximab (RTX) and to assess disease characteristics, RTX efficacy and safety. METHODS:We conducted a systematic literature review according to PRISMA guidelines by selecting articles with information on IgAV and RTX up to October 2019. We extracted data on patient characteristics, disease course, RTX efficacy and tolerance. The resulting database was analyzed with statistical software package SPSS v 22.0. RESULTS:Among the initial 161 articles found, 20 studies including 35 well-characterized IgAV patients treated with RTX were finally analyzed. Distribution by sex was similar, and the median age at diagnosis was 26 (range: 2 months to 70 years). Patients included were equally diagnosed at pediatric age and in the adulthood. Almost 90% of patients had renal involvement before RTX treatment and resistant or refractory disease to glucocorticoids or other immunosuppressive agents, mainly with renal impairment, was the reason for RTX administration in 85.7% of patients. RTX was used because of contraindication to these previous agents in 8.6% of patients, and as first line therapy in 5.7% of them. With regard to RTX response, 94.3% of patients presented clinical improvement of any type and 74.3% achieved sustained remission at the end of follow-up. Among the 13 (37.1%) patients who experienced a disease relapse, 11 (31.4%) were treated with a new RTX dose, with good disease control in all cases. In terms of treatment requirements, glucocorticoids and additional immunosuppressants were significantly lower after RTX administration. No deaths were observed and the rate of minor RTX-associated adverse effects was of 8.6%. CONCLUSION:RTX seems to be a safe and useful agent in inducing disease remission and reducing previous immunosuppressive treatment in IgAV pediatric and adult patients resistant or refractory to glucocorticoids or other immunosuppressive drugs, and in those patients in whom these agents are contraindicated. Nevertheless, controlled clinical trials in are still warranted to clarify the role of RTX in IgAV.


Autoimmun Rev


Autoimmunity reviews


Hernández-Rodríguez J,Carbonell C,Mirón-Canelo JA,Diez-Ruiz S,Marcos M,Chamorro AJ




Has Abstract


2020-04-01 00:00:00














  • P-glycoprotein in autoimmune diseases.

    abstract::Multidrug resistance-1 (MDR-1) is characterized by overfunction of P-glycoprotein (P-gp), a pump molecule that decreases intracellular drug concentration by effluxing them from the intracellular space. Broad ranges of structurally unrelated compounds are transported by P-gp, including antineoplastic agents, HIV protea...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Richaud-Patin Y,Soto-Vega E,Jakez-Ocampo J,Llorente L

    更新日期:2004-03-01 00:00:00

  • Mycobacterium tuberculosis heat shock proteins and autoimmunity in sarcoidosis.

    abstract::Sarcoidosis (SA) is a granulomatous disorder of an unknown etiology. Infectious, genetic factors and autoimmunity have been explored as potential causes of SA. Pathologic similarities between SA and tuberculosis (TB) suggest Mycobacterium tuberculosis, especially mycobacterial antigen(s) e.g. heat shock proteins (Mtb-...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Dubaniewicz A

    更新日期:2010-04-01 00:00:00

  • The dual nature of Ets-1: focus to the pathogenesis of systemic lupus erythematosus.

    abstract::E26 transformation-specific-1 (Ets-1) belongs to the Ets family of transcription factors which share a common 85-amino-acid DNA-binding domain. Ets-1 is essential to regulation of the immune system including immune cell proliferation and differentiation. Past data demonstrated Ets-1 play a role in negative regulation ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Leng RX,Pan HF,Chen GM,Feng CC,Fan YG,Ye DQ,Li XP

    更新日期:2011-06-01 00:00:00

  • Hashimoto thyroiditis: clinical and diagnostic criteria.

    abstract::Hashimoto thyroiditis (HT), now considered the most common autoimmune disease, was described over a century ago as a pronounced lymphoid goiter affecting predominantly women. In addition to this classic form, several other clinico-pathologic entities are now included under the term HT: fibrous variant, IgG4-related va...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Caturegli P,De Remigis A,Rose NR

    更新日期:2014-04-01 00:00:00

  • Usefulness of cardiovascular biomarkers and cardiac imaging in systemic rheumatic diseases.

    abstract::Systemic rheumatic diseases (SRDs) are associated with accelerated atherosclerosis. It has recently been recognised that chronic inflammation is an important factor in the development of atherosclerotic plaque and endothelial dysfunction. The levels of biomarkers such as serum pentraxin 3 (PTX3), an innate immunity pr...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Atzeni F,Turiel M,Hollan I,Meroni P,Sitia S,Tomasoni L,Sarzi-Puttini P

    更新日期:2010-10-01 00:00:00

  • Predictors of early relapse in patients with non-infectious mixed cryoglobulinemia vasculitis: results from the French nationwide CryoVas survey.

    abstract:OBJECTIVE:Although in most patients induction therapy leads to complete or partial remission, relapses in patients with non-infectious mixed cryoglobulinemia vasculitis (CryoVas) remain a major problem. We aimed to identify predictors of early relapses occurring within the first 12months of treatment in such patients. ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Terrier B,Marie I,Launay D,Lacraz A,Belenotti P,de Saint-Martin L,Quemeneur T,Huart A,Bonnet F,Le Guenno G,Kahn JE,Hinschberger O,Rullier P,Diot E,Lazaro E,Bridoux F,Zénone T,Carrat F,Hermine O,Léger JM,Mariette X

    更新日期:2014-06-01 00:00:00

  • Complex regional pain syndrome - False hopes and miscommunications.

    abstract::Complex regional pain syndrome (CRPS) has been considered to be an autoimmune disease and there have been clinical trials with intravenous immunoglobulin. Often the etiology of the so-called CRPS diagnosis cannot be discerned and there are no validated instruments that provide functional metrics. The term complex regi...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Chang C,McDonnell P,Gershwin ME

    更新日期:2019-03-01 00:00:00

  • Factors influencing polyautoimmunity in systemic lupus erythematosus.

    abstract:OBJECTIVE:Since characterization of the extent to which particular combinations of autoimmune diseases (ADs) occur in excess of that expected by chance may offer new insights into possible common pathophysiological mechanisms, polyautoimmunity (i.e., ADs co-occurring within patients) in systemic lupus erythematosus (SL...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章


    authors: Rojas-Villarraga A,Toro CE,Espinosa G,Rodríguez-Velosa Y,Duarte-Rey C,Mantilla RD,Iglesias-Gamarra A,Cervera R,Anaya JM

    更新日期:2010-02-01 00:00:00

  • Autoimmune comorbidity in chronic spontaneous urticaria: A systematic review.

    abstract:BACKGROUND AND OBJECTIVE:Numerous autoimmune diseases (AIDs) have been linked to chronic spontaneous urticaria (CSU). Here, we provide the first extensive and comprehensive evaluation of the prevalence of AIDs in patients with CSU and vice versa. METHODS:A Pubmed and Google Scholar search was performed to identify stu...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Kolkhir P,Borzova E,Grattan C,Asero R,Pogorelov D,Maurer M

    更新日期:2017-12-01 00:00:00

  • The role of nailfold capillaroscopy in the assessment of internal organ involvement in systemic sclerosis: A critical review.

    abstract::Endothelial dysfunction and microvascular damage constitute the hallmarks of systemic sclerosis (SSc), explaining much of the pathophysiology and clinical manifestations of the disease. Nailfold videocapillaroscopy (NVC) is an established method for the assessment of the microvasculature, aiding in distinguishing diff...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Soulaidopoulos S,Triantafyllidou E,Garyfallos A,Kitas GD,Dimitroulas T

    更新日期:2017-08-01 00:00:00

  • Switching TNF-alpha antagonists in rheumatoid arthritis: the experience of the LORHEN registry.

    abstract::New biologic agents have changed the paradigm of rheumatoid arthritis treatment, leading to improvement in managing patients' refractory to classical DMARDs. Anti-TNF-alpha is used as first-line treatment in patients failing to respond to classical DMARDs. However, up to 50% of patients fail to respond to these drugs ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章


    authors: Caporali R,Sarzi-Puttini P,Atzeni F,Gorla R,Filippini M,Marchesoni A,Favalli EG,Bobbio-Pallavicini F,Montecucco C

    更新日期:2010-04-01 00:00:00

  • The fresco of autoinflammatory diseases from the pediatric perspective.

    abstract::Autoinflammatory diseases are genetic or acquired clinical entities globally caused by the aberrant release of the proinflammatory cytokine interleukin-1 and mostly characterized by recurrent spontaneous inflammatory events which do not produce antigen-specific T cells or autoantibodies. Within the past decade, the li...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Rigante D

    更新日期:2012-03-01 00:00:00

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    abstract::Autoimmune diseases refer to a spectrum of diseases characterized by an active immune response against the host, which frequently involves increased autoantibody production. The pathogenesis of autoimmune diseases is multifactorial and the exploitation of novel effective treatment is urgent. Capsaicin is a nutritional...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Deng Y,Huang X,Wu H,Zhao M,Lu Q,Israeli E,Dahan S,Blank M,Shoenfeld Y

    更新日期:2016-05-01 00:00:00

  • Pulmonary renal vasculitis syndromes.

    abstract::The term pulmonary renal vasculitis syndrome describes a clinical syndrome of diffuse alveolar haemorrhage (DAH) complicating acute glomerulonephritis that often heralds severe, life-threatening systemic vasculitis requiring urgent, aggressive therapy. "Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Lee RW,D'Cruz DP

    更新日期:2010-08-01 00:00:00

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    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Bosello S,De Luca G,Tolusso B,Lama G,Angelucci C,Sica G,Ferraccioli G

    更新日期:2011-08-01 00:00:00

  • Prednisone in lupus nephritis: how much is enough?

    abstract:OBJECTIVE:To assess the effectiveness and safety of a protocol using medium doses of prednisone to treat lupus nephritis. METHODS:Patients receiving the 'Cruces-protocol cohort' (CPC) were paired 1:2 with patients from the 'historic cohort' (HC). The CPC received medium doses of prednisone combined with methyl-prednis...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章


    authors: Ruiz-Irastorza G,Danza A,Perales I,Villar I,Garcia M,Delgado S,Khamashta M

    更新日期:2014-02-01 00:00:00

  • Clinical associations of renal involvement in ANCA-associated vasculitis.

    abstract:OBJECTIVE:Renal involvement in anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis is associated with significant morbidity and higher mortality rates. This study examined clinical manifestations associated with renal involvement in ANCA-associated vasculitis within a large, international cross-sectional co...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Kronbichler A,Shin JI,Lee KH,Nakagomi D,Quintana LF,Busch M,Craven A,Luqmani RA,Merkel PA,Mayer G,Jayne DRW,Watts RA

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  • Prevalence of cervical HPV infection in women with systemic lupus erythematosus: A systematic review and meta-analysis.

    abstract:OBJECTIVE:The objectives of this systematic review and meta-regression were: 1) to compare the prevalence of cervical HPV infection between SLE patients and healthy controls and 2) to evaluate the relationship between cervical HPV infection and traditional and SLE-related risk factors for cervical HPV infection in thes...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,meta分析


    authors: García-Carrasco M,Mendoza-Pinto C,Rojas-Villarraga A,Molano-González N,Vallejo-Ruiz V,Munguía-Realpozo P,Colombo AL,Cervera R

    更新日期:2019-02-01 00:00:00

  • New insights into the pathogenesis of Behçet's disease.

    abstract::Behçet's disease (BD) is a recurrent systemic inflammatory disorder of unknown origin characterized by oral and genital mucous ulcer, uveitis, and skin lesions. Involvement of large vessels, central nervous system (CNS), gastrointestinal tract and thrombotic events are less frequent but can be life threatening. The ai...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Pineton de Chambrun M,Wechsler B,Geri G,Cacoub P,Saadoun D

    更新日期:2012-08-01 00:00:00

  • Churg-Strauss Syndrome: an evolving paradigm.

    abstract::The Churg-Strauss Syndrome is an ANCA-associated vasculitis, an inflammatory multisystem disease with preference to the respiratory tract. Peripheral and tissue eosinophilia are the pathological hallmarks of this condition. The etiopathogenesis is unknown but some cytokines appear to play a central role and could be t...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Ramentol-Sintas M,Martínez-Valle F,Solans-Laqué R

    更新日期:2012-12-01 00:00:00

  • Anti-aquaporin-4 auto-antibodies orchestrate the pathogenesis in neuromyelitis optica.

    abstract::NMO-IgG, the auto-antibody specific to the aquaporin-4 (AQP4) water channel associated with the autoimmune inflammatory disease neuromyelitis optica (NMO), is considered to be an accurate serum biomarker and is thought to be an important contributor to NMO pathology. In this review, we summarize recent evidences from ...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Saikali P,Cayrol R,Vincent T

    更新日期:2009-12-01 00:00:00

  • Is damage in central nervous system due to inflammation?

    abstract::The aim of this work was to review the inflammatory factors involved in central nervous system (CNS) inflammation and the damage associated to their participation in an inflammatory disease of CNS, multiple sclerosis in humans and experimental allergic encephalomyelitis in the murine model. Inflammation has an importa...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Chavarria A,Alcocer-Varela J

    更新日期:2004-06-01 00:00:00

  • Modulation of endothelial cell damages by anti-Hsp60 autoantibodies in systemic autoimmune diseases.

    abstract::Heat-shock protein (Hsp) family is made up of heterogeneous proteins of which Hsp60 members are the most studied. It is now generally admitted that Hsp60 is not only a mitochondrial component but can be localized on the membrane cell surface. Considered as a signal danger following infections, Hsp60 can induce the pro...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Alard JE,Dueymes M,Youinou P,Jamin C

    更新日期:2007-08-01 00:00:00

  • Intravenous immunoglobulin: exploiting the potential of natural antibodies.

    abstract::Antibodies present in healthy conditions in the absence of deliberate immunization or infections are called natural antibodies. A significant proportion of natural antibody pool is believed to interact with self-antigens, and thus is called natural autoantibodies. Natural autoantibodies belong to IgG, IgM and IgA subc...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Kaveri SV

    更新日期:2012-09-01 00:00:00

  • Mechanistic immunological based classification of rheumatoid arthritis.

    abstract::The classical autoimmunity paradigm in rheumatoid arthritis (RA) is strongly supported by immunogenetics suggesting follicular helper T-cell responses driving high titre specific autoantibodies that pre-dates disease onset. Using the immunological disease continuum model of inflammation against self with "pure" adapti...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: McGonagle D,Watad A,Savic S

    更新日期:2018-11-01 00:00:00

  • B-type natriuretic peptide in rheumatic diseases: a cardiac biomarker or a sophisticated acute phase reactant?

    abstract::Natriuretic peptides (NP) are secreted by cardiomyocytes and are reliable markers of cardiac dysfunction and cardiovascular risk by reflecting myocardial stress due to various etiologies. Clinical and occult heart involvement is frequently observed in patients with rheumatic diseases and is associated with increased m...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Dimitroulas T,Giannakoulas G,Karvounis H,Garyfallos A,Settas L,Kitas G

    更新日期:2012-10-01 00:00:00

  • CD28 superagonists put a break on autoimmunity by preferentially activating CD4+CD25+ regulatory T cells.

    abstract::There is strong evidence that a quantitative and/or functional deficiency in CD4+CD25+ regulatory T cells (T(reg) cells) plays a key role in the pathogenesis of many human autoimmune diseases. Therefore, targeting regulatory T cells with novel forms of immunotherapy should provide a means for successfully battling aut...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章


    authors: Beyersdorf N,Hanke T,Kerkau T,Hünig T

    更新日期:2006-01-01 00:00:00

  • Modulation of autoimmunity with artificial peptides.

    abstract::The loss of immune tolerance to self antigens leads to the development of autoimmune responses. Since self antigens are often multiple and/or their sequences may be known, one approach to restore immune tolerance uses synthetic artificial peptides that interfere or compete with self peptides in the networks of cellula...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: La Cava A

    更新日期:2010-11-01 00:00:00

  • Complex regional pain syndrome: a comprehensive and critical review.

    abstract::Complex regional pain syndrome (CRPS) is a term used to describe a variety of disorders characterized by spontaneous or stimulus-induced pain that is disproportional to the inciting event and accompanied by a myriad of autonomic and motor disturbances in highly variable combinations. There are no standards which can b...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Borchers AT,Gershwin ME

    更新日期:2014-03-01 00:00:00

  • Associated autoimmune diseases in children and adolescents with type 1 diabetes mellitus (T1DM).

    abstract::Type 1 diabetes (T1DM) is an autoimmune disease with aberrant immune responses to specific β-cell autoantigens, resulting in insulin deficiency. Children and adolescents with T1DM may also develop organ-specific multiple autoimmunity in the context of APS (autoimmune polyendocrine syndrome) type 1, 2 or 3. The most fr...

    journal_title:Autoimmunity reviews

    pub_type: 杂志文章,评审


    authors: Kakleas K,Soldatou A,Karachaliou F,Karavanaki K

    更新日期:2015-09-01 00:00:00