Looney R John
Allergy/Immunology and Rheumatology Unit, University of Rochester Medical Center, Rochester, New York, USA.
J Rheumatol Suppl. 2005 Feb;73:25-8; discussion 29-30.
There are now numerous case reports and small series using rituximab in autoimmune diseases. While these data must be interpreted with caution, they suggest that rituximab (RTX) may be a promising addition to the therapeutic armamentarium. In patients with refractory chronic idiopathic thrombocytopenic purpura, treatment with RTX was effective in inducing complete responses in a significant proportion of patients, and these responses were usually durable. RTX has also been shown to be effective and well tolerated in children with refractory autoimmune hemolytic anemia. In patients with IgM antibody-associated polyneuropathy, RTX improved muscle strength, and repeated treatments over 2 years were well tolerated. In several case series of patients with systemic lupus erythematosus, depletion of B cells during RTX therapy was associated with improvement in global disease activity. Based on these reports, further controlled studies are warranted to optimize RTX as monotherapy and to develop combination therapies in patients with refractory autoimmune diseases.
目前有大量关于在自身免疫性疾病中使用利妥昔单抗的病例报告和小样本系列研究。虽然这些数据必须谨慎解读，但它们表明利妥昔单抗（RTX）可能是治疗手段中有前景的补充药物。在难治性慢性特发性血小板减少性紫癜患者中，RTX治疗能使相当一部分患者有效诱导完全缓解，且这些缓解通常持久。RTX在难治性自身免疫性溶血性贫血儿童中也显示出有效且耐受性良好。在IgM抗体相关多神经病患者中，RTX改善了肌肉力量，并且2年多的重复治疗耐受性良好。在系统性红斑狼疮患者的几个病例系列中，RTX治疗期间B细胞的耗竭与整体疾病活动度的改善相关。基于这些报告，有必要进行进一步的对照研究，以优化RTX作为单一疗法，并为难治性自身免疫性疾病患者开发联合疗法。
