Department of Ophthalmology, University Vita-Salute, Scientific Institute San Raffaele, Via Olgettina 60, Milan, Italy.
Autoimmun Rev. 2011 Nov;11(1):35-9. doi: 10.1016/j.autrev.2011.07.001. Epub 2011 Jul 13.
Rituximab is a monoclonal antibody directed against the CD20 antigen expressed on B cells and widely used in the treatment of non-Hodgkin's lymphoma and rheumatoid arthritis. There is a growing amount of literature which suggests that rituximab may be useful for inflammatory ocular diseases and intraocular lymphoma. Few cases have been reported on treatment of refractory scleritis, peripherative ulcerative keratitis, uveitis and ocular surface inflammatory disorders. Rituximab may be effective in the treatment of ocular inflammatory diseases in particular the most aggressive, recalcitrant and sight-threatening forms of inflammation such as uveitis associated to juvenile idiopathic arthritis. We review the literature covering the use of Rituximab in these conditions and report our results on the efficacy of Rituximab in the treatment of 8 children with very severe and long-standing uveitis who failed to respond to one or more TNF blockers. Our patients showed improvement in activity of uveitis, reduction of concomitant corticosteroids and immunosuppressants after a mean follow-up time of 14.87 months on rituximab. No serious adverse events were encountered in our treated patients. Although further studies are needed for assessing the efficacy of rituximab and the exact dosing regimen, rituximab may be considered as a treatment alternative in patients with the most aggressive forms of inflammatory ocular diseases who fail to respond to conventional and anti-TNF immunosuppressive agents.
利妥昔单抗是一种针对 B 细胞表面表达的 CD20 抗原的单克隆抗体，广泛用于治疗非霍奇金淋巴瘤和类风湿关节炎。越来越多的文献表明，利妥昔单抗可能对炎症性眼病和眼内淋巴瘤有用。有少数关于难治性巩膜炎、周边溃疡性角膜炎、葡萄膜炎和眼表炎症性疾病治疗的病例报告。利妥昔单抗可能对眼部炎症性疾病有效，特别是对幼年特发性关节炎相关葡萄膜炎等最具侵袭性、难治性和威胁视力的炎症形式。我们回顾了涵盖利妥昔单抗在这些疾病中的应用的文献，并报告了我们在 8 例对一种或多种 TNF 阻滞剂反应不佳的非常严重和长期葡萄膜炎儿童中使用利妥昔单抗治疗的结果。我们的患者在利妥昔单抗治疗 14.87 个月后的平均随访时间内，葡萄膜炎活动度改善，同时减少皮质类固醇和免疫抑制剂的使用。我们治疗的患者均未出现严重不良事件。尽管需要进一步研究来评估利妥昔单抗的疗效和确切的剂量方案，但对于对常规和抗 TNF 免疫抑制剂治疗反应不佳的最具侵袭性的炎症性眼病患者，利妥昔单抗可被视为一种治疗选择。
