ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 2855

Efficacy and Safety of Rituximab Retreatment Regimen at Clinical Relapse in Severe Cryoglobulinemic Vasculitis

Luca Quartuccio1, Francesca Zuliani2, Patrizia Scaini3, Marco Lenzi4, Antonio Tavoni5, Marco Sebastiani6, Teresa Urraro7, Francesco Saccardo8, Costanza Sbreglia9, Pietro Pioltelli10, Paolo Fraticelli11, Davide Filippini12, Salvatore Scarpato13, Oreste Perrella9, Armando Gabrielli14, Dario Roccatello15, Anna Linda Zignego16, Clodoveo Ferri17, Stefano Bombardieri18, Maurizio Pietrogrande19, Massimo Galli20, Giuseppe Monti8 and Salvatore De Vita1, 1Rheumatology, DSMB, University Hospital Santa Maria della Misericordia, Udine, Italy, 2Rheumatology Clinic, University Hospital of Udine, Udine, Italy, 3Nephrology, Spedali Civili di Brescia, Brescia, Italy, 4University of Bologna, Bologna, Italy, 5Rheumatology Clinic, University of Pisa, Pisa, Italy, 6Rheumatology Clinic, University of Modena and Reggio Emilia, Modena, Italy, 7Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy, 8Internal Medicine Unit, Saronno Hospital, Azienda Ospedaliera di Busto Arsizio, Saronno (VA), Italy, 9Rheumatology Unit, AO Cotugno, Naples, Italy, 10Hematology, S.Gerardo Hospital, Monza, Italy, 11Istituto di Clinica Medica, Università Politecnica delle Marche, Ancona, Italy, 12Rheumatology Unit, Ospedale Niguarda Ca’ Granda, Milan, Italy, 13Rheumatology Unit, M. Scarlato Hospital, Scafati, Salerno, Italy, 14Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy, 15CORSO RAFFAELLO 30, UNIVERSITY OF TURIN (ITALY), TURIN, Italy, 16University of Florence, Center for Systemic Manifestations of Hepatitis Viruses (MASVE), Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy, 17Internal Med/Rheumatology, Univ Modena Reggio Emilia, Modena, Italy, 18Rheumatology Unit, University of Pisa, Pisa, Italy, 19Internal Medicine Unit, Policlinico San Marco, Bergamo, Italy, 20Istituto di Malattie Infettive e Tropicali, Università di Milano c/o Ospedale L. Sacco, Milano, Italy

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Cryoglobulinemia, Hepatitis C, rituximab and vasculitis

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Title: Vasculitis III

Session Type: Abstract Submissions (ACR)

Background/Purpose: Two independent controlled randomized trials recently reported the efficacy and safety of rituximab (RTX) monotherapy in severe cryoglobulinemic vasculitis (CV) (1, 2), with one reporting a follow-up lasting two years (1). The aim of this study is to report the very long term efficacy and safety of a retreatment regimen with RTX administered at clinical relapse after the end of the abovementioned trial (1).

Methods: Long term follow up data of a trial of RTX in severe CV (1) were analysed, by considering patients managed with retreatent with RTX at clinical relapse. During this follow-up, only RTX monotherapy was used. Number of retreatments, disease activity at last follow up, adverse events and causes of deaths were registered. Clinical response was evaluated at the last follow-up visit, as follows: i) complete response (remission), partial response (response > 50% of at least one manifestation among glomerulonephritis, severe neuropathy or skin ulcers) (1), and active disease despite treatment.

Results: After the end of the 24-month controlled trial (1), follow-up data were analysed in 30 patients, all positive for hepatitis C virus infection. The mean follow up after the beginning of RTX therapy (1) was 72.6±20.4 months, including 24 (80%) patients followed for more than 4 years and 6 (20%) patients followed for 2.4-4 years. Of them, 21 patients were still under an active follow up, 3 patients were lost from follow-up shortly after the end of the trial, and 6 patients died. Survival of RTX regimen was 7.6±0.3 yrs (mean±standard error). Seventeen out of 30 (56.7%) patients needed a retreatment for relapse; of them, 6/30 were retreated during the trial, 10/30 only after the end of the trial and 1/30 during both follow-up periods, accounting for 25 retreatments in total, the first one at a mean of  22.3 ± 12.1 months from last RTX cycle during the trial. Patients were retreated for nephritis (7/25), neuropathy (12/25), skin ulcers (6/25) or widespread purpura (6/25). Of the 17 patients retreated, 6/17 (35.3%) showed complete response at the last follow-up, 5/17 (29.4%) a partial response, while 6/17 (35.3%) had an active disease. Interestingly, of the remaining 13/30 patients undergoing only one single course of RTX during the follow-up, 6/13 were still in active follow-up and in clinical remission at the last follow-up. Recurrent infections occurred in three patients (10%; urinary and upper respiratory), related to severe hypogammaglobulinemia (IgG < 3 g/l) in 2/3. Death occurred in 6 patients. However, only 2/6 deaths were linked to relapsed vasculitis, with new onset of intestinal vasculitis.

Conclusion: A long-term RTX monotherapy with a retreatment at relapse regimen is effective and safe in cryoglobulinemic vasculitis, with low rate of severe hypogammaglobulinemia. Clinicians should be aware to promptly recognize and treat clinical relapse, as well as concomitant infections. Relapses with life-threatening manifestations (i.e. intestinal vasculitis) were uncommon. Further investigation may be required to select patients where maintenance RTX therapy may be the best choice.

References:

1) De Vita S, et al. Arthritis Rheumatol. 2012;64(3):843-53.

2) Sneller MC, et al. Arthritis Rheumatol. 2012;64(3):835-42.


Disclosure:

L. Quartuccio,
None;

F. Zuliani,
None;

P. Scaini,
None;

M. Lenzi,
None;

A. Tavoni,
None;

M. Sebastiani,
None;

T. Urraro,
None;

F. Saccardo,
None;

C. Sbreglia,
None;

P. Pioltelli,
None;

P. Fraticelli,
None;

D. Filippini,
None;

S. Scarpato,
None;

O. Perrella,
None;

A. Gabrielli,
None;

D. Roccatello,
None;

A. L. Zignego,
None;

C. Ferri,
None;

S. Bombardieri,
None;

M. Pietrogrande,
None;

M. Galli,
None;

G. Monti,
None;

S. De Vita,
None.

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/efficacy-and-safety-of-rituximab-retreatment-regimen-at-clinical-relapse-in-severe-cryoglobulinemic-vasculitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology