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  • Efficacy of rituximab in primary Sjögren's syndrome with peripheral nervous system involvement: results from the AIR registry

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Clinical and epidemiological research
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Efficacy of rituximab in primary Sjögren's syndrome with peripheral nervous system involvement: results from the AIR registry
  1. A Mekinian1,
  2. P Ravaud2,
  3. P Y Hatron3,
  4. C Larroche4,
  5. J Leone5,
  6. B Gombert6,
  7. M Hamidou7,
  8. A Cantagrel8,
  9. C Marcelli9,
  10. S Rist10,
  11. M Breban11,
  12. D Launay3,
  13. O Fain1,
  14. J E Gottenberg12,
  15. X Mariette13
  1. 1Department of Internal Medicine, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud 13, Bondy, France
  2. 2Clinical Research Department, Hôpital Hotel Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud 5, Paris, France
  3. 3Department of Internal Medicine, Hôpital Claude Huriez, Université Lille II, Lille, France
  4. 4Department of Internal Medicine, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud 13, Bobigny, France
  5. 5Department of Internal Medicine, Hôpital Universitaire Reims, Reims, France
  6. 6Department of Internal Medicine, Hôpital La Rochelle, La Rochelle, France
  7. 7Department of Internal Medicine, Hôpital Universitaire de Nantes, Nantes, France
  8. 8Department of Rheumatology, Hôpital Universitaire de Toulouse, Toulouse, France
  9. 9Department of Rheumatology, Hôpital Universitaire de Caen, Caen, France
  10. 10Department of Rheumatology, Hôpital de Orleans, Orleans, France
  11. 11Department of Rheumatology, Hôpital Ambroise Paré, Université de Versailles St-Quentin-en Yvelines-Paris Ile de France-Ouest, Assistance Publique-Hôpitaux de Paris (AP-HP), Boulogne-Billancourt, France
  12. 12Department of Rheumatology, EA 4438, Physiopathologie des Arthrites, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
  13. 13Department of Rheumatology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud 11, Institut Pour la Santé et la Recherche Médicale (INSERM) U 1012, Le Kremlin Bicêtre, France
  1. Correspondence toProfessor X Mariette, Service de Rhumatologie, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris-Sud 11, Institut Pour la Santé et la Recherche Médicale (INSERM) U 1012, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France; xavier.mariette{at}bct.aphp.fr

Abstract

Objective To evaluate rituximab (RTX) in primary Sjögren's syndrome (pSS) with peripheral nervous system (PNS) involvement.

Methods Patients with pSS and PNS involvement who were included in the French AIR registry were analysed.

Results 17 patients (age 60 years (44–78 years); 14 were female) were analysed.

Neurological improvement was noted in 11 patients (65%) at 3 months. Rankin scale decreased from 3 (1–5) to 2 (1–5), 2 (1–5) and 2 (1–6) after 3, 6 and 9 months (p=0.02). European Sjögren's Syndrome Disease Activity Index decreased from 18 (10–44) to 11 (5–20), 11 (5–29) and 12 (5–30) after 3, 6 and 9 months (p<0.05).

RTX was effective in neurological involvement in 9/10 patients with vasculitis or cryoglobulinaemia (90%) (group 1) at 3 months and in 2/7 cases (29%) without cryoglobulinaemia and vasculitis (p=0.03). Rankin and European Sjögren's Syndrome Disease Activity Index scales decreased significantly in group 1.

Conclusion RTX seems effective in cryoglobulinaemia or vasculitis-related PNS involvement in pSS.

https://doi.org/10.1136/annrheumdis-2011-200086

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    Footnotes

    • Competing interests PYH, CL, SR, JEG and XM were investigators of the TEARS phase II study evaluating the efficacy of RTX promoted by the university hospital of Brest and funded by Roche.

    • Ethics approval The study was approved by the Kremlin Bicêtre Ethic Committee.

    • Provenance and peer review Not commissioned; internally peer reviewed.