SC Ematologia, Azienda Sanitaria Universitaria Integrata Trieste, Italy.
SC Ematologia, Azienda Sanitaria Universitaria Integrata Trieste, Italy
Haematologica. 2019 Jun;104(6):1124-1135. doi: 10.3324/haematol.2019.218883. Epub 2019 May 24.
The use of rituximab for the treatment of immune thrombocytopenia was greeted enthusiastically: it led to up to 60% response rates, making it, nearly 20 years ago, the main alternative to splenectomy, with far fewer side effects. However, long-term follow-up data showed that only 20-30% of patients maintained the remission. No significant changes have been registered using different dose schedules and timing of administration, while the combination with other drugs seemed promising. Higher response rates have been observed in young women before the chronic phase, but apart from that, other clinical factors or biomarkers predictive of response are still lacking. In this review we examine the historical and current role of rituximab in the management of immune thrombocytopenia, 20 years after its first use for the treatment of autoimmune diseases.
它使反应率高达 60%，使其在近 20 年前成为脾切除术的主要替代疗法，且副作用要少得多。然而，长期随访数据显示，只有 20-30%的患者能维持缓解。不同的剂量方案和给药时间并没有显著改变，而与其他药物联合使用似乎很有前景。在慢性期之前，年轻女性的反应率较高，但除此之外，其他预测反应的临床因素或生物标志物仍然缺乏。在这篇综述中，我们探讨了利妥昔单抗在免疫性血小板减少症治疗中的历史和当前作用，这是它首次用于治疗自身免疫性疾病后的 20 年。
