Comparison of cryoglobulinemia vasculitis (CV) according to the presence of a disease flare following RTX.
| Variables | Patients with Vasculitis Flare, n = 7* | Patients without Vasculitis Flare, n = 43 | p |
|---|---|---|---|
| Demographic characteristics | |||
| Sex, male | 5 (71) | 21 (49) | |
| Age, median (min) [max] | 75.0 (54.0–78.0) [34.0–83.0] | 56.0 (49.0–67.0) [24.0–79.0] | 0.15 |
| Characteristics of CV | |||
| Type II cryoglobulin | 7 (100) | 34 (81) | 0.58 |
| IgM κ | 7 (100) | 29 (88) | 1 |
| Cryoglobulinemic level at diagnosis, g/l, median (IQR) | 2.1 (1.7–2.5) | 0.4 (0.2–0.8) | 0.0004 |
| Etiology of CV | |||
| Essential | 1 (14) | 4 (9) | 0.55 |
| Lymphoproliferation associated to HCV | 4 (57) | 5 (12) | 0.015 |
| Autoimmune disease | 1 (14) | 6 (14) | 1 |
| HCV infection | 6 (86) | 31 (72) | 0.66 |
| Comorbidities | |||
| Cirrhosis | 3 (43) | 6 (14) | 0.38 |
| Hepatocellular carcinoma | 1 (14.3) | 2 (5) | |
| Clinical characteristics of CV | |||
| Fever | 1 (12) | 4 (7) | 0.48 |
| Renal involvement | 7 (88) | 14 (23) | 0.0008 |
| Skin manifestations (purpura, ulcers) | 7 (88) | 36 (60) | 0.24 |
| Neuropathy | 6 (75) | 29 (48) | 0.26 |
| Digestive involvement | 2 (25) | 3 (5) | 0.10 |
| Cardiac involvement | 0 (0) | 2 (3) | 1 |
| Biological features | |||
| Cryoglobulinemia level, g/l, median (IQR) | 1.4 (0.8–1.8) | 0.4 (0.1–1.3) | 0.10 |
| Creatinemia, µmol/l, median (IQR) | 96.5 (68.2–128.2) | 71.0 (63.0–90.8) | 0.22 |
| Gammaglobulin level, g/l, median (IQR) | 2.9 (2.6–5.0) | 10.1 (6.0–14.9) | 0.005 |
| C4 level, g/l, median (IQR) | 0.02 (0.01–0.04) | 0.05 (0.03–0.09) | 0.023 |
| Treatments associated with RTX | |||
| Plasmapheresis | 1 (12) | 8 (14) | 1 |
| Corticosteroids | 3 (38) | 21 (35) | 1 |
| Pulses of corticosteroids | 1 (12) | 4 (7) | 0.48 |
| Corticosteroids at 1 mg/kg | 1 (12) | 6 (10) | 1 |
| Chemotherapy | 1 (12) | 9 (15) | 1 |
| Protocol of RTX | |||
| 1 g | 1 (12.5) | 5 (8.3) | |
| 375 mg/m2 | 7 (87.5) | 55 (91.7) |
↵* 7 patients with 8 flares. Values are n (%) unless otherwise specified. RTX: rituximab; IQR: interquartile range; HCV: hepatitis C virus.