title: [Review of the current use of rituximab during 4 years in a French university hospital].
abstract: OBJECTIVE
  Rituximab is a human/murine chimeric monoclonal antibody primarily used for treating non-Hodgkin's B-cell lymphoma. Recently, it has also been used in the treatment of several autoimmune diseases.
  
  
  METHODS
  We conducted a retrospective analysis of patients treated at least once with rituximab between 2010 and 2013 in a French university hospital, to provide a panoramic view of rituximab use including FDA or off-labels uses, its efficacy and safety.
  
  
  RESULTS
  Eighty-seven patients were included with 20 different indications: cryoglobulinemic vasculitis (16%) and anti-PLA2R idiopathic membranous nephropathy (13%) were the most frequent. Rituximab use was off-labels in 50% of cases. Eleven percent of patients experienced severe adverse events, mostly infections. After rituximab, 17% of patients were in complete response (CR), 41% in partial response (PR), and 39% non-responding (NR). Relapse was observed in 65% (33/51) of responding patients.
  
  
  CONCLUSIONS
  Further investigation with randomized controlled trials will provide more insight into the specifics of the role of RTX in the overall management of each disease. Identifying clear objectives and strict outcome measures, associated with long term clinical and biological follow-up would help deciding when, how and in which therapeutic regimen will rituximab most benefit a disease or a patient.
authors: Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. Electronic address: quitteriereynaud@gmail.com.
authors: Q
authors: Q
authors: Reynaud
authors: Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors: M
authors: M
authors: Killian
authors: Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors: A
authors: A
authors: Robles
authors: Service de pharmacie, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors: F
authors: F
authors: Mounsef
authors: Service de neurologie, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors: J-P
authors: JP
authors: Camdessanché
authors: Service de néphrologie et transplantation, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors: C
authors: C
authors: Mariat
authors: Service de médecine interne, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors: P
authors: P
authors: Cathébras
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000188:drug therapy*; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab
keywords: Autoimmune disease; Maladies auto-immunes; Recommandations de bon usage; Rituximab