Stachnik Joan M
Department of Pharmacy Practice, College of Pharmacy, University of Illinois Medical Center at Chicago, 60612-7229, USA.
Ann Pharmacother. 2006 Jun;40(6):1151-7. doi: 10.1345/aph.1G658. Epub 2006 May 30.
To review published literature evaluating the use of rituximab for treatment of acquired hemophilia.
An English-language literature search was conducted using MEDLINE (1966-January 2006). References of identified articles were subsequently reviewed for additional data. Search terms included rituximab, acquired hemophilia, and inhibitors.
Available data suggest that B-cell depletion by rituximab in patients with acquired hemophilia may contribute to the eradication of inhibitors to coagulation factors. B-cells have been shown to be essential in the development of autoimmunity or an acquired immune response. Beneficial effects of rituximab, after failure of established therapies, have been reported in case reports and one small, open-label trial.
Although data are limited, administration of rituximab appears to be an effective option for treatment of patients with acquired hemophilia after established therapies have failed. Patients given rituximab experienced cessation of recurrent bleeding, normalization of factor VIII activity, and eradication of inhibitors. A complete response to rituximab (undetectable inhibitors, normalization of factor levels) generally occurred several weeks to months after initiation of therapy.
回顾已发表的评估利妥昔单抗治疗获得性血友病的文献。
使用MEDLINE（1966年 - 2006年1月）进行了英文文献检索。随后对已识别文章的参考文献进行了回顾以获取更多数据。检索词包括利妥昔单抗、获得性血友病和抑制剂。
现有数据表明，利妥昔单抗使获得性血友病患者的B细胞耗竭可能有助于消除凝血因子抑制剂。已证明B细胞在自身免疫或获得性免疫反应的发展中至关重要。在病例报告和一项小型开放标签试验中，已报道在既定疗法失败后利妥昔单抗具有有益效果。
尽管数据有限，但在既定疗法失败后，给予利妥昔单抗似乎是治疗获得性血友病患者的有效选择。接受利妥昔单抗治疗的患者出血复发停止、因子VIII活性恢复正常且抑制剂消除。对利妥昔单抗的完全反应（抑制剂检测不到、因子水平正常化）通常在治疗开始后数周至数月出现。
