Cutaneous improvement in refractory adult and juvenile dermatomyositis after treatment with rituximab
Cutaneous improvement in refractory adult and juvenile dermatomyositis after treatment with rituximab
复制标题
DOI：
10.1093/rheumatology/kew396
复制
发表时间：
2017-02-01
期刊：
影响因子：
5.5
通讯作者：
Oddis, Chester V.
中科院分区：
文献类型：
--
作者：
Aggarwal, Rohit;Loganathan, Priyadarshini;Oddis, Chester V.
目标。目的是评估利妥昔单抗对成人DM和jdm皮肤表现的疗效。在一项随机安慰剂期对照试验中，难治性成人DM （n = 72）和JDM （n = 48）患者接受利妥昔单抗治疗[要么是利妥昔单抗早期用药（第0/1周），要么是利妥昔单抗晚期用药（第8/9周），这样所有受试者都接受了研究药物]。允许稳定的伴随治疗。使用肌炎疾病活动性评估工具评估皮肤疾病活动性，该工具根据视觉模拟量表对皮肤疾病活动性进行分级。肌炎损伤评估工具，称为肌炎损伤指数，用于评估皮肤损伤。利妥昔单抗治疗后的改善在个体皮疹以及皮肤疾病活动性和损伤评分中进行了评估。采用chi(2)检验、Student’s配对t检验和Wilcoxon检验进行分析。在成人糖尿病和JDM亚群中，使用利妥昔单抗后，从基线到试验结束，皮肤疾病活动度均有显著改善。成人DM （3.22-1.72, P = 0.0002）和JDM （3.26-1.56, P = 0.0002）的皮肤视觉模拟量表活性有所改善
Objective. The aim was to assess the efficacy of rituximab for the cutaneous manifestations of adult DM and JDM.Methods. Patients with refractory adult DM (n = 72) and JDM (n = 48) were treated with rituximab in a randomized placebo-phase-controlled trial [either rituximab early drug (week 0/1) or rituximab late arms (week 8/9), such that all subjects received study drug]. Stable concomitant therapy was allowed. Cutaneous disease activity was assessed using the Myositis Disease Activity Assessment Tool, which grades cutaneous disease activity on a visual analog scale. A myositis damage assessment tool, termed the Myositis Damage Index, was used to assess cutaneous damage. Improvement post-rituximab was evaluated in individual rashes as well as in cutaneous disease activity and damage scores. The chi(2) test, Student's paired t-test and Wilcoxon test were used for analysis.Results. There were significant improvements in cutaneous disease activity from baseline to the end of the trial after rituximab administration in both adult DM and JDM subsets. The cutaneous visual analog scale activity improved in adult DM (3.22-1.72, P = 0.0002) and JDM (3.26-1.56, P