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RITUXIMAB: NEW RESOURCES OF MANAGEMENT OF SEVERE REFRACTORY JUVENILE RHEUMATOID ARTHRITIS

Abstract

The management of severe juvenile rheumatoid arthritis (JRA) is a complicated problem. The efficacy and safety of Rituximab was investigated in 32 infliximabrefractory patients with different types of JRA, who had failed standard immunosuppressive therapy. Rituximab induced remission in 52% of patients. Rituximab was well tolerated, some patients experienced infusionbrelated adverse events, infections of upper airways and neutropenias. It's recommended to carry out a management of patients with JRA in specialized rheumatological centers with modern diagnostic and medicamental technologies because of subsequent adverse events.
Key words: children, management, rituximab, B cells, juvenile rheumatoid arthritis.

About the Authors

E.I. Alexeeva
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


T.М. Bzarova
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


S.I. Valieva
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


K.B. Isaeva
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


A.M. Chomakhidze
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


E.L. Semikina
Scientific Center of Children's Health, Russian Academy of Medical Sciences, Moscow
Russian Federation


References

1. Firestein G.S. Evolving concepts of rheumatoid arthritis. Nature. 2003; 423: 356–361.

2. Panayi G.S. The immunopathogenesis of rheumatoid arthritis. Br. J. Rheumatol. 1993; 32 (Suppl. 1): 4–14.

3. Edwards J.C., Cambridge G., Abrahams V.M. Do self perpetuating B lymphocytes drive human autoimmune disease? Immunology. 1999; 97: 188–196.

4. Edwards J.C., Szczepanski L., Szechinski J. Efficacy of B-Cell Targeted Therapy with Rituximab in Patients with Rheumatoid Arthritis. N. Engl. J. Med. 2004; 350: 2572–2581.

5. Leandro M.J., Edwards J.C., Cambridge G. Clinical outcome in 22 patients with rheumatoid arthritis treated with B lymphocyte depletion. Ann. Rheum. Dis. 2002; 61: 883–888.

6. Leandro M.J., Edwards J.C., Cambridge G. et al. An open study of B lymphocyte depletion in systemic lupus erythematosus. Arthritis Rheum. 2002; 46: 2673–2677.

7. Oligino T.J., Dalrymple S.A. Targeting B cells for the treatment of rheumatoid arthritis. Arthritis Res. Ther. 2003; 5 (Suppl. 4): 7–11.

8. Gause A., Berek C. The role of B cells in the pathogenesis of rheumatoid arthritis: potential implications for treatment. Bio Drugs. 2001; 15: 73–79.

9. Zhang Z., Bridges S.L. Jr. Pathogenesis of rheumatoid arthritis: role of B lymphocytes. Rheum. Dis. Clin. North. Am. 2001; 27: 335–353.

10. Daming Shan, Jeffrey A. Ledbetter, and Oliver W. Press Apoptosis of Malignant Human B Cells by Ligation of CD20 with Monoclonal Antibodies. Blood. 2006; 91: 1644–1652.

11. McLaughlin P., GrilloBLopez A.J., Link B.K. et al. Rituximab chimeric antiBCD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four dose treatment program. J. Clin. Oncol. 1998; 16: 2825–2833.

12. Panayi G.S. B cellBdirected therapy in rheumatoid arthritis — clinical experience. J. Rheumatol. Suppl. 2005; 73: 19–24.

13. Plosker G.L., Figgitt D.P. Rituximab: a review of its use in non-Hodgkin’s lymphoma and chronic lymphocytic leukaemia. Drugs. 2003; 63: 803–843.

14. Hainsworth John D. Safety of rituximab in the treatment of B cell malignancies: implications for rheumatoid arthritis. Arthritis Res. Ther. 2003; 5 (Suppl. 4): 12–16.

15. Anolik J.H., Campbell D., Felgar R.E. et al. The relationship of FcgammaRIIIa genotype to degree of B cell depletion by rituximab in the treatment of systemic lupus erythematosus. Arthritis Rheum. 2003; 48: 455–459.

16. Bhat N.M., Lee L.M., van Vollenhoven R.F. et al. VH4B34 encoded antibody in systemic lupus erythematosus: effect of isotype. J. Rheumatol. 2002; 29: 2114–2121.

17. Pugh-Bernard A.E., Silverman G.J., Cappione A.J. et al. Regulation of inherently autoreactive VH4B34 B cells in the maintenance of human B cell tolerance. J. Clin. Invest. 2001; 108: 1061–1070.

18. Leandro M.J., Ehrenstein M.R., Edwards J.C., et al. Treatment of refractory lupus nephritis with B lymphocyte depletion. Arthritis. Rheum. 2003; 48: 378.

19. Patel K., Berman J., Ferber A. et al. Refractory autoimmune thrombocytopenic purpura treatment with rituximab. Am. J. Hematol. 2001; 67: 59–60.

20. Stasi R., Pagano A., Stipa E. et al. Rituximab chimeric antiCD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura. Blood. 2001; 98: 952–957.

21. Berentsen S., Tjonnfjord G.E., Brudevold R. et al. Favourable response to therapy with the antiBCD20 monoclonal antibody rituximab in primary chronic cold agglutinin disease. Br. J. Haematol. 2001; 115: 79–83.

22. Quartier P., Brethon B., Philippet P. et al. Treatment of childhood autoimmune haemolytic anaemia with rituximab. Lancet. 2001; 358: 1511–1513.

23. Zecca M., Nobili B., Ramenghi U. et al. Rituximab for the treatment of refractory autoimmune hemolytic anemia in children. Blood. 2003; 101: 3857–3861.

24. Ruggenenti P., Chiurchiu C., Brusegan V. et al. Rituximab in idiopathic membranous nephropathy: a oneByear prospective study. J. Am. Soc. Nephrol. 2003; 14: 1851–1857.

25. Levine T.D. Rituximab in the treatment of dermatomyositis: an open label pilot study. Arthritis Rheum. 2005; 52 (2): 601–607.

26. Xiao X., Heeringa P., Hu P. et al. Antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase cause glomerulonephritis and vasculitis in mice. J. Clin. Invest. 2002; 110: 955–963.

27. Eriksson P. Short term outcome and safety in 5 patients with ANCABpositive vasculitis treated with rituximab: 11th International Vasculitis and ANCA Workshop 2003. Kidney Blood Pressure Res. 2003; 26: 294.

28. Jayne D., Burns S., Smith K. A prospective, open label trial of B cell depletion with rituximab in refractory systemic vasculitis. 11th International Vasculitis and ANCA Workshop 2003. Kidney Blood Pressure Res. 2003; 26: 294.

29. Edwards J.C., Cambridge G. Sustained improvement in rheumatoid arthritis following a protocol designed to deplete lymphocytes. Rheumatology. 2001; 40: 205–211.

30. Looney R.J., Anolik J., Sanz I. B cells as therapeutic targets for rheumatic diseases. Current Opinion Rheumatology. 2004; 16: 180–185.

31. Stahl H.D., Szczepanski L., Szechinski J. et al. Rituximab in RA: efficacy and safety from a randomized controlled trial. Ann. Rheum. Dis. 2003; 62: 65.

32. Emery P., Szczepanski L., Szechinski J. et al. Sustained efficacy at 48 weeks after a single treatment course of rituximab in patients with RA. Arthritis Rheum. 2003; 48: 439.


Review

For citations:


Alexeeva E., Bzarova T., Valieva S., Isaeva K., Chomakhidze A., Semikina E. RITUXIMAB: NEW RESOURCES OF MANAGEMENT OF SEVERE REFRACTORY JUVENILE RHEUMATOID ARTHRITIS. Current Pediatrics. 2008;7(2):22-29.

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ISSN 1682-5527 (Print)
ISSN 1682-5535 (Online)