Rituximab in the treatment of eosinophilic granulomatosis with polyangiitis

Abstract

Background: The general consensus is that for patients with EGPA with poor prognosis, intensive therapy with both GC and CF is indicated. The maintenance of remission is made with GC and AZA. A considerable number of patients with EGPA are refractory to first line therapy, experience dose-limiting side effects or relapse. In clinical trials, RTX was effective for the treatment of ANCA-associated vasculitis. However, patients with a diagnosis of EGPA were not included.

Objective: to review and analyze the published literature regarding the use of RTX in the treatment of EGPA.

Methods: The literature search was performed in MEDLINE and LILACS from 1965 and 1986 respectively until february 2014.

Results: 27 patients were included. RTX treatment was due to refractory disease (n=20), relapse (n=5) and with newly diagnosed (n=2). The affected organs were the lungs, peripheral nervous system, kidney and the eyes. Sixteen patients had clinical remission and 8 patients had clinical response.

Conclusions: RTX was effective and well tolerated for the treatment of EGPA.

Keywords: Anti-neutrophil cytoplasmic antibody-associated vasculitis; Eosinophilic granulomatosis with polyangiitis; Granulomatosis eosinofilica con poliangitis; Rituximab; Vasculitis asociadas a anticuerpos anticitoplasma de neutrófilo.