Low-Dose Rituximab for Active Moderate to Severe Graves' Orbitopathy Resistant to Conventional Treatment. (4th July 2019)

• Record Type: Journal Article
• Authors: Du Pasquier-Fediaevsky, Laurence; Andrei, Stefan; Berche, Michel; Leenhardt, Laurence; Héron, Emmanuel; Rivière, Sébastien
• Is Part Of: Ocular immunology and inflammation. Volume 27:Number 5(2019)
• Page Start: 844
• Page End: 850
• Publication Date: 2019-07-04
• Subjects: Corticoresistant -- Graves' orbitopathy -- low-dose -- rituximab -- treatment; Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.1080/09273948.2018.1453078
• Languages: English
• ISSNs: 0927-3948

Abstract

ABSTRACT: Purpose : To report low-dose rituximab effect in Graves' orbitopathy (GO) resistant to conventional treatment. Methods : Retrospective analysis of medical records, filled in according to the European Group on Graves' Orbitopathy (EUGOGO) standards, of patients with active moderate-to-severe GO who received low-dose rituximab after failure of conventional treatment. Efficacy was defined by a decrease of the clinical activity score of 2 points or <4/10. Results : Among 219 patients treated between 2012 and 2016 by pulse methylprednisolone, possibly followed by oral steroids and/or orbital radiotherapy, 15 (6.8%) finally received 100 mg rituximab doses (cumulative dose, 100–400 mg) owing to persistent active disease. Rituximab showed efficacy within 2 months in 13 of 15 (87%), stable at 1 year. No significant effect was observed on proptosis, lid fissure width, and eye motility. Conclusion : Low-dose rituximab showed sustained anti-inflammatory effect in most patients with active GO resistant to conventional treatment.