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The impact of two different rituximab-based strategies in cryoglobulinaemic vasculitis secondary to Sjögren’s disease: a monocentric cohort study
S. Longhino1, E. Treppo2, V. Manfrè3, M. De Martino4, M.T. Rizzo5, M. Isola6, S. De Vita7, L. Quartuccio8
- Rheumatology Division, Department of Medicine (DMED), University of Udine, Italy.
- Rheumatology Division, Department of Medicine (DMED), University of Udine, Italy.
- Rheumatology Division, Department of Medicine (DMED), University of Udine, Italy.
- Institute of Statistics, Department of Medicine (DMED), University of Udine, Italy.
- Rheumatology Division, Department of Medicine (DMED), University of Udine, Italy.
- Institute of Statistics, Department of Medicine (DMED), University of Udine, Italy.
- Rheumatology Division, Department of Medicine (DMED), University of Udine, and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy.
- Rheumatology Division, Department of Medicine (DMED), University of Udine, and Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy. luca.quartuccio@uniud.it
CER17625
2024 Vol.42, N°12
PI 2387, PF 2392
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PMID: 39269017 [PubMed]
Received: 02/03/2024
Accepted : 11/04/2024
In Press: 13/09/2024
Published: 19/12/2024
Abstract
OBJECTIVES:
To compare two different rituximab (RTX)-based therapeutic approaches on vasculitic and lymphoproliferative-related disease activity and on non-Hodgkin lymphoma (NHL) development in a cohort of patients affected by cryoglobulinaemic vasculitis secondary to Sjögren’s disease (Sjögren-CryoVasc).
METHODS:
Three Sjögren-CryoVasc treatment groups were identified: 1) early RTX induction followed by maintenance; 2) late RTX induction with possible on-demand retreatment; 3) no RTX treatment. The following outcomes were evaluated: a) changes in cumulative ESSDAI, considering vasculitic-related and lymphoproliferative-related domains and changes in ESSDAI specific to each single vasculitic-related and lymphoproliferative-related domain; b) development of NHL; c) occurrence of persistent hypogammaglobulinemia associated with serious infections.
RESULTS:
13 Sjögren-CryoVasc patients were identified: 1) 5/13 treated earlier with RTX with subsequent maintenance; 2) 5/13 treated late with RTX with possible on-demand retreatment; 3) 3/13 not treated with RTX. The two RTX groups showed a decrease in the ESSDAI score with group 1 showing the most substantial reduction (p=0.028). Patients receiving RTX exhibited significant improvement in cutaneous, PNS, and articular vasculitic-related ESSDAI domains (p=0.007; p=0.006; p=0.03, respectively). By contrast RTX did not greatly affect the lymphoproliferative-related ESSDAI domains, even if an improvement was noted in the glandular and nodal domains for group 1 (p=0.03; p=0.03, respectively). No differences in NHL occurrence or safety concerns were observed between the groups.
CONCLUSIONS:
RTX is an effective and safe treatment to control Sjögren-CryoVasc disease activity with a greater impact when administered earlier with a maintenance regimen. RTX alone cannot, however, affect the possible evolution of Sjögren-CryoVasc into an overt NHL.
