PMID- 11762944
OWN - NLM
STAT- MEDLINE
DCOM- 20020108
LR  - 20220331
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 44
IP  - 12
DP  - 2001 Dec
TI  - Response of Wegener's granulomatosis to anti-CD20 chimeric monoclonal antibody 
      therapy.
PG  - 2836-40
AB  - We report on the successful, compassionate use of the anti-CD20 chimeric 
      monoclonal antibody rituximab in a patient with chronic, relapsing cytoplasmic 
      antineutrophil cytoplasmic antibody (cANCA)-associated Wegener's granulomatosis 
      (WG). The patient initially responded to treatment with glucocorticoids and 
      cyclophosphamide. However, bone marrow toxicity during cyclophosphamide treatment 
      of a relapse precluded its further use. Azathioprine and mycophenolate mofetil 
      treatment had failed to maintain remission of the WG, and methotrexate was 
      contraindicated. Because the patient's 5-year course was characterized by close 
      correlation of cANCA levels with disease activity, selective elimination of cANCA 
      was deemed a treatment option for his latest relapse. He was given 4 infusions of 
      375 mg/M2 of rituximab and high-dose glucocorticoids. Complete remission was 
      associated with the disappearance of B lymphocytes and cANCA. Glucocorticoid 
      treatment was then discontinued. After 11 months, the cANCA recurred, and 
      rituximab therapy was repeated, without glucocorticoids. At 8 months after the 
      second course of rituximab (18 months after the first course), the patient's WG 
      has remained in complete remission. Elimination of B cells by rituximab therapy 
      may prove to be an effective and safe new treatment modality for ANCA-associated 
      vasculitis and possibly other autoimmune diseases. This modality warrants closer 
      examination in a carefully conducted clinical trial.
FAU - Specks, U
AU  - Specks U
AD  - Division of Pulmonary and Critical Care Medicine, Mayo Clinic and Foundation, 
      Rochester, MN 55905, USA. specks.ulrich@mayo.edu
FAU - Fervenza, F C
AU  - Fervenza FC
FAU - McDonald, T J
AU  - McDonald TJ
FAU - Hogan, M C
AU  - Hogan MC
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - 0 (Antibodies, Antineutrophil Cytoplasmic)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Antigens, CD20)
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Immunoglobulin A)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Immunoglobulin M)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
MH  - Aged
MH  - Antibodies, Antineutrophil Cytoplasmic/blood
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Murine-Derived
MH  - Antigens, CD20/*immunology
MH  - Antineoplastic Agents/*therapeutic use
MH  - Granulomatosis with Polyangiitis/immunology/*therapy
MH  - Humans
MH  - Immunoglobulin A/blood
MH  - Immunoglobulin G/blood
MH  - Immunoglobulin M/blood
MH  - Lymphocyte Count
MH  - Male
MH  - Remission Induction
MH  - Rituximab
EDAT- 2002/01/05 10:00
MHDA- 2002/01/10 10:01
CRDT- 2002/01/05 10:00
PHST- 2002/01/05 10:00 [pubmed]
PHST- 2002/01/10 10:01 [medline]
PHST- 2002/01/05 10:00 [entrez]
AID - 10.1002/1529-0131(200112)44:12<2836::aid-art471>3.0.co;2-w [doi]
PST - ppublish
SO  - Arthritis Rheum. 2001 Dec;44(12):2836-40. doi: 
      10.1002/1529-0131(200112)44:12<2836::aid-art471>3.0.co;2-w.