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Efficacy of low-dose rituximab for mixed cryoglobulinemia.

机译:小剂量利妥昔单抗对混合性冷球蛋白血症的疗效。

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摘要

Rituximab at 375 mg/m(2) x 4 is effective for refractory HCV-related mixed cryoglobulinemia. We conducted a pilot study to assess the efficacy of a lower dosage, 250 mg/m(2) x 2. Six consecutive patients with mixed cryoglobulinemia were treated. All patients had severe or life-threatening disease manifestations, including necrotizing skin ulcers, renal disease, hyperviscosity or intestinal vasculitis. Four of five evaluable patients (excluding one early death) had >80% decrease of cryocrit and remission of vasculitis at the end of a 22- to 55-week (median 40) follow-up. The non-responder failed to respond to additional rituximab treatment, suggesting intrinsic resistance rather than insufficient dosage as the cause of treatment failure. No sustained increase of HCV viremia after rituximab was observed. Rituximab at 250 mg/m(2) x 2 may be as effective as at 375 mg/m(2) x 4 for treating mixed cryoglobulinemia. Larger studies are required to assess the efficacy of low-dose rituximab.
机译:利妥昔单抗375 mg / m(2)x 4可有效治疗难治性HCV相关性混合性冷球蛋白血症。我们进行了一项初步研究,以评估较低剂量250 mg / m(2)x 2的疗效。连续治疗了6名混合性冷球蛋白血症患者。所有患者均具有严重或危及生命的疾病表现,包括坏死性皮肤溃疡,肾脏疾病,高黏度或肠道血管炎。在22到55周(中位数40)的随访结束时,五位可评估的患者中有四位(不包括一例早期死亡)的冰冻比降低和血管炎缓解率降低了80%以上。无反应者对其他利妥昔单抗治疗无效,提示内在耐药性而非剂量不足是治疗失败的原因。观察到利妥昔单抗后HCV病毒血症没有持续增加。利妥昔单抗250 mg / m(2)x 2可能与375 mg / m(2)x 4一样有效,可治疗混合性冷球蛋白血症。需要更大的研究来评估低剂量利妥昔单抗的疗效。

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