rituximab

Dr LAUNAY David, interniste, LillePr MARIETTE Xavier, rhumatologue, BicêtrePr MOUTHON Luc, interniste, ParisGroupe de lectureSociété Nationale Française de Médecine InternePr COMBE Bernard, rhumatologue, MontpellierPr DURIEU Isabelle, interniste, Pierre BénitePr FAUTREL Bruno, rhumatologue, ParisPr HACHULLA Eric, interniste, LillePr HAMIDOU Mohamed, interniste, NantesPr JEGO Patrick, interniste, RennesDr MASSON Charles, rhumatologue, AngersDr PAGNOUX Christian, interniste, ParisDr PUECHAL Xavier, interniste, Le MansPr ROUSSET Hugues, interniste, Pierre BénitePr SIBILIA Jean, rhumatologue, StrasbourgDr VANHILLE Philippe, interniste, ValenciennesComité de qualificationPr CAULIN Charles, Président, thérapeutique, ParisPr AULAGNER Gilles, pharmacien, représentant desHCL, LyonMme BONGRAND Marie-Claude, pharmacien,représentante des Pharmaciens de CHU, MarseilleDr DUMARCET Nathalie, AfssapsDr CHASSANY Olivier, méthodologiste, ParisMme FAUCHER-GRASSIN Joëlle, pharmacien,représentante des Pharmaciens de CHU PoitiersPr LAVILLE Maurice, praticien hospitalier,représentant des HCL, LyonMme MONTAGNIER-PETRISSANS Catherine,pharmacien, représentante de la Juste prescription del’AP-HP, ParisM. LIEVRE Michel, pharmacologue, LyonMme PIVOT, pharmacien, représentante des HCLLyonPr RICHÉ Christian, pharmacologue, BrestM. ROPERS Jacques, AfssapsDr ROSENHEIM Michel, médecin de santé publique,ParisPr VICAUT Eric, médecin de santé publique, ParisLa Commission d’AMM du 10 mai 2007 présidée par le Pr Daniel VITTECOQ n’a pas émis d’objectionà ce référentiel, qui a également été visé par la Commission de la transparence de la HAS, présidéepar le Pr Gilles BOUVENOT.Résumés-abstractsAries PM, Hellmich B, Voswinkel J, Both M, Nolle B, Holl-Ulrich K, Lamprecht P, Gross WL. Lack of efficacy ofrituximab in Wegener's granulomatosis with refractory granulomatous manifestations. Ann Rheum Dis. 2006 Jul;65(7):853-8.OBJECTIVE: To investigate the safety and efficacy of rituximab (RTX) in patients with refractory Wegener'sgranulomatosis (WG). PATIENTS AND METHODS: Eight consecutive patients with active refractory WG wereincluded. In all patients disease activity had persisted despite standard treatment with cyclophosphamide andprednisolone, as well as tumour necrosis factor alpha blockade 3 months before inclusion in the study. Patientshad particular granulomatous manifestations like retro-orbital granulomata (n = 5), nodules of the lungs (n = 1),and subglottic stenosis (n = 2). RTX was given intravenously every 4th week in combination with the standardtreatment in five patients and with methotrexate in two others. Disease extent and activity were monitoredclinically by interdisciplinary care, immunodiagnostics (ANCA serology, B cells by flow cytometry), and magneticresonance imaging. RESULTS: Beneficial response and a reduction in disease activity were seen in threepatients, two of whom went into complete remission. In three other patients, disease activity remained unchangedwhile the disease progressed in the remaining two patients. In all patients peripheral blood B cells fell to zeroduring treatment with RTX. cANCA titres remained unchanged in all except one patient. CONCLUSION: In thispilot study, B lymphocyte depletion was not associated with a change of the ANCA titres or obvious clinicalimprovement of refractory granulomatous disease in patients with WG. Further studies are needed to evaluate therole of RTX in WG.Eriksson P. Nine patients with anti-neutrophil cytoplasmic antibody-positive vasculitis successfully treated withrituximab. J Intern Med. 2005 Jun;257(6):540-8.OBJECTIVES: Rituximab (RIT) is a monoclonal anti-CD20 antibody, which depletes B-lymphocytes but notplasma cells. RIT is used for treatment of B-cell lymphomas, but has also shown beneficial effects in autoimmunediseases. In this case series RIT was used in anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis.DESIGN: Case series with a structured follow-up of treated patients. SETTING: Departments of Nephrology andRheumatology of a university hospital. SUBJECTS: Two women with myeloperoxidase-ANCA-positive- 26 -