Rituximab treatment of patients with severe, corticosteroid-resistant thyroid-associated ophthalmopathy.
Rituximab treatment of patients with severe, corticosteroid-resistant thyroid-associated ophthalmopathy.
复制标题
DOI：
10.1016/j.ophtha.2009.05.029
复制
发表时间：
2010-01
期刊：
影响因子：
13.7
通讯作者：
Douglas RS
中科院分区：
文献类型：
--
作者：
Khanna D;Chong KK;Afifiyan NF;Hwang CJ;Lee DK;Garneau HC;Goldberg RA;Darwin CH;Smith TJ;Douglas RS
研究抗 CD20（Rituximab、RTX、Rituxan®、Genentech Inc. USA）治疗对严重、皮质类固醇 (CS) 耐药的甲状腺相关眼病 (TAO) 患者的有效性。回顾性介入病例系列 连续 6 名患有严重、进行性 TAO 的受试者对 CS 无反应。对过去 18 个月内连续接受 RTX 的患者进行电子病历审查。使用标准临床评估和外周淋巴细胞的流式细胞术分析对治疗反应进行分级。临床活动评分 (CAS)、突眼、斜视、治疗副作用和调节性 T 细胞的定量。对六名患者进行了研究。全身性CS未能改变所有患者的临床活动（CAS=治疗前5.3+1.0（平均值+标准差），治疗7.5+6.4个月期间为5.5+0.8，p=1.0）。然而，RTX 治疗后，治疗后 2 个月时 CAS 从 5.5 + 0.8 改善至 1.3 + 0.5 (p<0.03)，并且在 6.2 + 4.5 个月的随访中，所有患者均保持静止状态 (CAS=0.7 + 0.8；p≤0.0001)。所有 4 名甲状腺功能障碍性视神经病变 (DON) 患者的双侧视力均得到改善。六名患者在 RTX 输注后均未出现疾病复发，且眼球突出保持稳定（治疗前 Hertel 测量值 = 24 + 3.7mm，治疗后为 23.6 + 3.7mm，p = 0.17）。对一名患者进行评估后，T 调节细胞的丰度在 RTX 治疗后一周内有所增加，并在 18 个月的随访中保持较高水平。在进行性、CS 耐药性 TAO 中，RTX 治疗后眼眶炎症和 DON 快速持续消退。
To study the effectiveness of anti-CD20 (Rituximab, RTX, Rituxan®, Genentech Inc. USA) therapy in patients with severe, corticosteroid (CS)-resistant thyroid-associated ophthalmopathy (TAO). Retrospective interventional case series Six consecutive subjects with severe, progressive TAO unresponsive to CS. Electronic medical record review of consecutive patients receiving RTX during the previous 18 months. Responses to therapy were graded using standard clinical assessment and flow-cytometric analysis of peripheral lymphocytes. Clinical activity score (CAS), proptosis, strabismus, treatment side-effects, and quantification of regulatory T cells. Six patients were studied. Systemic CS failed to alter clinical activity in all patients (CAS= 5.3 + 1.0 (mean + standard deviation) before vs 5.5 + 0.8 during therapy for 7.5+ 6.4 months, p=1.0). However following RTX treatment, CAS improved from 5.5 + 0.8 to 1.3 + 0.5 at 2 months post treatment (p<0.03) and remained quiescent in all patients (CAS=0.7 + 0.8; p≤0.0001) at 6.2 + 4.5 month follow-up. Vision improved bilaterally in all 4 patients with dysthyroid optic neuropathy (DON). None of the six patients experienced disease relapse following RTX infusion and proptosis remained stable (Hertel measurement = 24 + 3.7mm before and 23.6 + 3.7mm after therapy, p=0.17). The abundance of T regulatory cells, assessed in one patient, increased within one week of RTX and remained elevated at 18 month follow-up. In progressive, CS-resistant TAO, rapid and sustained resolution of orbital inflammation and DON followed treatment with RTX.
登录
查看更多内容
影响因子：
5.8
作者：
Aniszewski, JP;Valyasevi, RW;Bahn, RS
通讯作者：
Bahn, RS
影响因子：
4.1
作者：
MOURITS, MP;KOORNNEEF, L;VANDERGAAG, R
通讯作者：
VANDERGAAG, R
影响因子：
4.2
作者：
BARTLEY, GB;GORMAN, CA
通讯作者：
GORMAN, CA
DOI：
10.1002/art.23715
发表时间：
2008-06-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Keystone, E.;Burmester, G. R.;Jost, F.
通讯作者：
Jost, F.
影响因子：
8.6
作者：
Salvi, Mario;Vannucchia, Guia;Beck-Peccoz, Paolo
通讯作者：
Beck-Peccoz, Paolo