title: Rituximab in the treatment of TTP.
abstract: Thrombotic thrombocytopenic purpura (TTP) is an acute life threatening disorder, for which mortality remains relatively unchanged since the introduction of plasma therapy. Improved understanding of the pathophysiology has identified that the majority of cases result from antibodies directed against ADAMTS 13, which is required to cleave von Willebrand Factor. The use of monoclonal anti-CD 20 therapy removes IgG antibodies, resulting in increased ADAMTS 13 activity, improved time to remission and prevention of recurrent relapses. While further follow-up is required, the side effect profile of anti-CD 20 therapy appears improved compared to conventional immunosuppressive treatments. The use of ADAMTS 13 activity for monitoring can identify patients at risk of a TTP relapse and preemptive therapy with an anti-CD 20 can be considered.
authors.affiliation: University College London Hospitals, London, UK. m.scully@ucl.ac.uk
authors.forename: Marie
authors.initials: M
authors.lastname: Scully
mesh_terms: D051722:ADAM Proteins / Q000276:immunology; D000071120:ADAMTS13 Protein; D058846:Antibodies, Monoclonal, Murine-Derived / Q000276:immunology / Q000627:therapeutic use*; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007155:Immunologic Factors / Q000276:immunology / Q000627:therapeutic use*; D011697:Purpura, Thrombotic Thrombocytopenic / Q000188:drug therapy* / Q000276:immunology; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007074:Immunoglobulin G; D007155:Immunologic Factors; D000069283:Rituximab; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human