Friday, 20 Jul 2018

You are here

Rituximab Efficacy in IgG4 Related Disease

PLOS reports  greater than 90% efficacy when rituximab (RTX) is used to treat patients with IgG4-related disease (IgG4-RD). 

The diagnosis and management of IgG4-RD is challenging and often without proven trial-based evidence.  A French national retrospective multicenter study examined the efficacy of RTX given to 33 patients with IgG4-RD. This RTX treated cohort was drawn from a total of 156 IgG4-RD patients in the French database.

A clinical response was noted in nearly all patients - 29/31 (93.5%) improved and steroid withdrawal was achieved in over half the patients (51.5%).

During a mean follow-up of 24 months, 13/31 (41.9%) of the RTX responding patients relapsed a mean of 19 months after RTX. 

Patients with active disease (IgG4-RD Responder Index >9) before RTX were more likely to relapse (HR = 3.68, 95% CI: 1.1, 12.6) (P = 0.04), whereas maintenance RTX therapy was associated with longer relapse-free survival (41 versus 21 months; P = 0.02). 

Important adverse effects included 8 serious infections in 4 patients (rate = 12.1/100 patient-years) and hypogammaglobulinemia was seen in 3 patients.

RTX is effective for both induction and maintenance therapy for IgG4-RD, but relapses are frequent after B-cell reconstitution. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Defining Refractory RA by Biologic Use

A study from the  British Society for Rheumatology Biologics Register (BSRBR) has shown that biologic refractory disease is seen in at least 6% of patients who have ever received a biologic DMARD (bDMARDs).

IL-23 Inhibitor Fails in Ankylosing Spondylitis

A study of the IL-23 risankizumab in active ankylosing spondylitis (AS) patients failed to show efficacy and did not meet primary efficacy endpoints in a 6-month trial.

Five Barriers to Biosimilar Adoption in the US

A recent Deloitte analysis of the biosimilar market in the USA suggests there are defined obstacles to biosimilar use that must be dealt with, especially as the current administration is seeking to lower drug prices and reduce out-of-pocket costs for US consumers.

EULAR 2018 - Day 4 Report

The EULAR 2018 wound down on Saturday with fewer oral presentations but many posters.  In my last report I put together a collection of impressions and some thematic highlights not covered in previous reports. Also some of these represent research and reporting trends – some healthy, others not so – that were evident at the EULAR 2018 meeting.

Pain 

High Biologic Blood Levels Increases the Risk of Infections in RA

A big concern of most is the risk of infection with use of tumour necrosis factor inhibitor (TNFi) and biologic drugs.  While studied in both trials and in post-marketing studies, it is unknown if infection risk is dose-dependent.

In abstract OP0229 UK researchers have shown high biologic blood levels are associates with an increased risk of total infections in RA, but not serious infetions.