[Evaluation of the effectiveness of treatment with rituximab associated to cyclophosphamide in patients with resistant idiopathic inflammatory myopathy].
OBJECTIVE
We report our experience with rituximab plus cyclophosphamide in the treatment of patients with resistant idiopathic inflammatory myopathies.


METHODS
Open-label uncontrolled prospective study on 17 patients.


RESULTS
Evaluation was completed after 1, 6 and 12 months in 95'2, 85'7 y 52'4% of cycles, respectively. Total or partial remission was achieved after 1, 6 and 12 months in 65, 100 y 63'6% of evaluated cycles, respectively. Absolute depletion of B lymphocites from peripheral blood was found in the 18 cases with available data. There were 5 relapses; median of time to relapse: 11 months; treatment was repeated in 4. Four patients (6 cycles) had impaired pulmonary function; one (with a multifactorial etiology) did not improve but the other 3, with interstitial pneumonia associated or not with respiratory muscle weakness, did. Five patients with positive anti-Jo-1 antibodies (6 cycles) displayed similar results. The only adverse event observed was a case of meningitis caused by Corynebacterium, with good results.


CONCLUSIONS
Rituximab seems a valid alternative for the treatment of patients with resistant polymyositis or dermatomyosytis.
Servicio de Medicina Interna, Unidad de Colagenosis e Hipertensión Pulmonar, Hospital Universitario Virgen del Rocío, Sevilla, España. fjgarciah@eresmas.com
Francisco José
FJ
García Hernández
Eduardo
E
Chinchilla Palomares
María Jesús
MJ
Castillo Palma
Cristina
C
González Pulido
Celia
C
Ocaña Medina
Julio
J
Sánchez Román
D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D003882:Dermatomyositis / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009220:Myositis / Q000188:drug therapy / Q000276:immunology; D012008:Recurrence; D012074:Remission Induction; D012120:Respiration Disorders / Q000209:etiology; D000069283:Rituximab; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D000069283:Rituximab; D003520:Cyclophosphamide