Rituximab in the treatment of inflammatory myopathies: a review

Rheumatology (Oxford). 2017 Jan;56(1):26-36. doi: 10.1093/rheumatology/kew146. Epub 2016 Apr 27.

Abstract

Several uncontrolled studies have encouraged the use of rituximab (RTX) in patients with myositis. Unfortunately, the first placebo-phase trial to assess the efficacy of RTX in refractory myositis did not show a significant difference between the two treatment groups, and doubts have been expressed about its study design. In this review we present an up-to-date overview of the reported experiences of RTX therapy in myositis. A PubMed search was performed to find all the available cases of refractory myositis patients treated with RTX up to July 2015. The following terms were assessed: inflammatory myopathies OR anti-synthetase syndrome OR polymyositis OR dermatomyositis AND RTX. A total of 48 studies were included. We identified 458 patients with myositis treated with RTX. We found a rate of response to RTX of 78.3%. RTX can play a role in the management of patients with myositis, at least in those with positive myositis-specific autoantibodies.

Keywords: anti-synthetase syndrome; dermatomyositis; inflammatory myopathies; polymyositis; rituximab.

Publication types

  • Review

MeSH terms

  • Antibodies, Antinuclear / immunology
  • Antirheumatic Agents / therapeutic use*
  • Autoantibodies / immunology
  • Autoantigens / immunology
  • Dermatomyositis / drug therapy
  • Dermatomyositis / immunology
  • Humans
  • Mi-2 Nucleosome Remodeling and Deacetylase Complex / immunology
  • Myositis / drug therapy*
  • Myositis / immunology
  • Polymyositis / drug therapy
  • Polymyositis / immunology
  • Rituximab / therapeutic use*
  • Treatment Outcome

Substances

  • Antibodies, Antinuclear
  • Antirheumatic Agents
  • Autoantibodies
  • Autoantigens
  • CHD4 protein, human
  • Jo-1 antibody
  • Rituximab
  • Mi-2 Nucleosome Remodeling and Deacetylase Complex

Supplementary concepts

  • Antisynthetase syndrome