CHICAGO—About 30 years ago, pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) began to outpace renal crisis as the main causes of death in scleroderma (SSc). But treating these lung complications has proved vexing for clinicians. There is no easy way to predict who will develop PAH. There is no telltale antibody and no…
Pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) features significant morbidity and mortality. Standard therapies with endothelin receptor antagonists and phosphodiesterase-5 inhibitors have shown some clinical improvement in patients, but these clinical improvements have proved modest when compared with other types of PAH. As our case below suggests, rituximab may show promise as a…
According to a large cohort study of pediatric patients, rituximab use is on the rise in the treatment of children diagnosed with vasculitis. Treatment with cyclophosphamide remains common, but it’s beginning to wane. Dialysis and mechanical ventilation also remain common, the study indicates. The retrospective study of hospitalized children in the U.S. included the largest…
Two biosimilar treatments, Rixathon and Imraldi, are moving closer to market release in Europe for the treatment of rheumatic and other diseases…
Although rituximab is not indicated for adults with SLE, a recent review suggests that it may be safe and effective for treating pediatric SLE. The review found that rituximab improved renal function and reduced proteinuria in pediatric patients. It may also prevent relapse and improve disease activity…
A recent study examined the relationship between increased BMI and antineutrophil cytoplasmic antibody–associated vasculitis treatment with glucocorticoids. The results: Weight gain was independently associated with reductions in disease activity, increased glucocorticoid exposure and randomization to rituximab. The most significant increases in BMI occurred during the first six months of treatment, and newly diagnosed patients were more likely to experience an increase in BMI…
These researchers investigated whether rituximab, an anti-B cell therapy, improves symptoms of fatigue and oral dryness in patients with primary Sjögren’s syndrome (SS). The multicenter, randomized, double-blind, placebo-controlled, parallel-group trial included a health economic analysis. There were no significant improvements in any outcome measure with rituximab except for unstimulated salivary flow. The study concludes that rituximab is neither clinically effective nor cost effective in this patient population…
The clinical practice guidelines for managing Sjögren’s syndrome, developed by the Sjögren’s Syndrome Foundation with the ACR, were designed to improve quality and consistency of care. In total, 19 recommendations were agreed on, which include managing the rheumatic and systemic aspects of the disease. Recommendations include a decision tree for the use of DMARDs for inflammatory musculoskeletal pain, use of self-care measures and exercise to reduce fatigue, and the use of rituximab in selected clinical settings for oral and ocular dryness…
GCA Relapse Possible When Discontinuing Tocilizumab In a Phase 2 randomized, controlled trial, tocilizumab, an anti-IL-6 biologic agent, was shown to induce and maintain remission for up to 52 weeks in patients with giant cell arteritis (GCA).1 During this trial, patients with GCA were randomized in a 2:1 ratio to receive 8 mg/kg bodyweight tocilizumab…
NEW YORK—Rituximab may be an effective treatment for recalcitrant dermatitis herpetiformis (DH), according to a recent case study. “DH is an autoimmune blistering disease which is commonly associated with celiac disease and can present with debilitating pruritic blisters on extensor surfaces,” explained Dr. Ron Feldman of Emory University School of Medicine. “The most common treatments…