Rituximab Induction and Maintenance Treatment in Patients with Scleritis and Granulomatosis with Polyangiitis (Wegener's)

Ocul Immunol Inflamm. 2018;26(8):1166-1173. doi: 10.1080/09273948.2017.1327602. Epub 2017 Jun 19.

Abstract

Aims: To evaluate the efficacy and safety of rituximab (RTX) induction and maintenance treatment for patients with scleritis and granulomatosis with polyangiitis (GPA), Wegener's.

Methods: Nine patients (12 eyes) with scleritis with GPA who did not respond to corticosteroids and more than one immunosuppressive agent who received ongoing maintenance RTX treatment were identified. Demographics and outcome measures were recorded.

Results: Median follow-up time of 30 months (range, 15 to 87 months). All 12 eyes achieved remission during the RTX maintenance period with a median time in remission of 14 months (range, 5-76 months), and median interval between RTX initiation and inactive disease of 5 months (range, 2-8 months). Two eyes in two patients relapsed. One received steroid eye drops, and the other received a short-term increased dose of intravenous corticosteroids.

Conclusions: RTX was effective as an induction and maintenance treatment in our small cohort of patients with GPA-associated scleritis.

Keywords: Inflammation; sclera and episclera; treatment medical.

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Granulomatosis with Polyangiitis / diagnosis
  • Granulomatosis with Polyangiitis / drug therapy*
  • Granulomatosis with Polyangiitis / physiopathology
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Maintenance Chemotherapy
  • Male
  • Middle Aged
  • Remission Induction
  • Retrospective Studies
  • Rituximab / adverse effects
  • Rituximab / therapeutic use*
  • Scleritis / diagnosis
  • Scleritis / drug therapy*
  • Scleritis / physiopathology
  • Treatment Outcome
  • Young Adult

Substances

  • Immunologic Factors
  • Rituximab