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Shams Ilyas, Christopher Holmes, Hema Kolli, Efrosini Papagiannuli, Susan Mollan, Matthew Morgan, Alastair Denniston; Efficacy and Safety of Rituximab in the Treatment of Ophthalmic Complications of Systemic Vasculitis.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1812.
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Rituximab, a monoclonal antibody against CD-20 expressing B-cells, is increasingly used in systemic vasculitis, but there is limited data on its utility in ocular inflammation associated with these conditions. To evaluate the efficacy and safety of rituximab in the treatment of inflammatory eye disease associated with systemic vasculitis.
Patients receiving rituximab for non-cancer indications were identified from the pharmacy chemotherapeutic register between 2005-2014. Indication for treatment, eye involvement, response to therapy, reduction of corticosteroid and adverse events/discontinuation were recorded. The primary outcome was control of inflammation.
119 patients received rituximab for non-cancer indications, with 91 classified as systemic vasculitis (52 Granulomatosis with Polyangiitis (GPA), 29 Systemic Lupus Erythematosus (SLE) and 10 Other). In total 25 patients had ophthalmic involvement. The leading type of ophthalmic involvement were scleritis (n = 9). Sustained control of inflammation (for at least 28 days) was 38% within 6 months, and 80% within 12 months. Of those previously on a dose of greater than 10mg prednisolone, reduction to 10 mg or less was achieved by 36% at 6 months and by 62% by at 12 months respectively. Rituximab was discontinued prematurely in two patients because of adverse events, one for facial swelling the other for possible serum sickness reaction.
Our data suggests that rituximab is effective for the majority of patients with inflammatory eye disease associated with systemic vasculitis. The rate of adverse events were low.
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