Rituximab treatment for persistent scleritis associated with rheumatoid arthritis.
OBJECTIVE
To report a clinical case of a patient with severe scleritis associated with rheumatoid arthritis (RA) refractive to conventional treatment that was treated effectively with rituximab.


RESULTS
A 55-year-old man with RA, on etanercept and oral methotrexate, was referred with diagnosis of acute stromal keratitis, anterior uveitis, and anterior nodular scleritis in his right eye. Cyclophosphamide induced complete regression of acute stromal keratitis and anterior uveitis, but scleritis was still active and persistent. After two 1000-mg infusions of rituximab, scleritis regressed completely and is still in remission 9 months after the second rituximab infusion, without any concomitant use of oral steroids.


CONCLUSIONS
Rituximab may be a treatment alternative in severe scleritis that is refractive to conventional therapy. Considering its safety profile, further studies are needed to refine its mechanism of action, optimal indications, and dosing in ocular inflammation.
Iaccheri
Barbara
B
Department of Ophthalmology, Santa Maria della Misericordia Hospital, University of Perugia, Perugia, Italy. barbaraiaccheri@libero.it
Androudi
Sofia
S
Bocci
Elena Bartoloni
EB
Gerli
Roberto
R
Cagini
Carlo
C
Fiore
Tito
T
D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D000069283:Rituximab; D015423:Scleritis / Q000188:drug therapy* / Q000209:etiology
D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab