Use of rituximab in idiopathic retroperitoneal fibrosis
Abstract Background Retroperitoneal fibrosis (RPF) is characterized by the proliferation of fibrous tissue in the retroperitoneum. The majority of RPF cases are due to idiopathic or IgG4-related disease. Recent studies on IgG4-related disease have shown rituximab to be an effective treatment. The cu...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-08-01
|
Series: | BMC Rheumatology |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s41927-020-00140-9 |
id |
doaj-959e0e1995104679a389541db1dda9ea |
---|---|
record_format |
Article |
spelling |
doaj-959e0e1995104679a389541db1dda9ea2020-11-25T03:31:54ZengBMCBMC Rheumatology2520-10262020-08-01411710.1186/s41927-020-00140-9Use of rituximab in idiopathic retroperitoneal fibrosisVeronika Boyeva0Hatim Alabsi1Michael A. Seidman2Ryan Paterson3Jason Kur4Luke Y. C. Chen5Silvia D. Chang6Mollie Carruthers7Department of Medicine, University of British ColumbiaDepartment of Radiology, King Abdulaziz UniversityDepartment of Pathology, University of British ColumbiaDepartment of Urology, University of British ColumbiaDepartment of Medicine, Division of Rheumatology, University of British ColumbiaDepartment of Medicine, Division of Hematology, University of British ColumbiaDepartment of Radiology, University of British ColumbiaArthritis Research CanadaAbstract Background Retroperitoneal fibrosis (RPF) is characterized by the proliferation of fibrous tissue in the retroperitoneum. The majority of RPF cases are due to idiopathic or IgG4-related disease. Recent studies on IgG4-related disease have shown rituximab to be an effective treatment. The current first-line treatment for idiopathic RPF (iRPF) is glucocorticoid therapy. Relapse rates vary widely in the literature, and DMARDs remain poorly studied. We sought to evaluate the efficacy of rituximab in idiopathic RPF by quantifying changes in iRPF diameter on imaging pre- and post-rituximab therapy and response by lab parameters in 10 iRPF patients. Methods We selected 10 patients diagnosed with iRPF and previously treated with rituximab (1000 mg) in two doses approximately 2 weeks apart. Pre- and post-therapy contrast enhanced cross-sectional abdomen and pelvis imaging were compared. In all patients, the thickest portion of the peri-aortic disease was measured in the axial and coronal planes. The presence of acute or long standing back pressure related renal findings were documented. Details of clinical visits including patient demographics and laboratory evaluations were collected pre- and post-therapy. Statistical analysis was performed using a Wilcoxon signed rank test. Results The RPF diameter around the aorta before and after therapy decreased from a mean of 15.9 ± 4.9 mm to 10.6 ± 6.1 mm, respectively (p < 0.01). The craniocaudal iRPF mean length decreased from 108.6 mm ± 40.4 mm to 90.6 mm ± 45.9 mm (p = 0.02). Conclusion A comparison of pre and post-rituximab imaging studies revealed a statistically significant decrease in iRPF diameter following treatment with rituximab.http://link.springer.com/article/10.1186/s41927-020-00140-9iRPFRPFRTXIgG4 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Veronika Boyeva Hatim Alabsi Michael A. Seidman Ryan Paterson Jason Kur Luke Y. C. Chen Silvia D. Chang Mollie Carruthers |
spellingShingle |
Veronika Boyeva Hatim Alabsi Michael A. Seidman Ryan Paterson Jason Kur Luke Y. C. Chen Silvia D. Chang Mollie Carruthers Use of rituximab in idiopathic retroperitoneal fibrosis BMC Rheumatology iRPF RPF RTX IgG4 |
author_facet |
Veronika Boyeva Hatim Alabsi Michael A. Seidman Ryan Paterson Jason Kur Luke Y. C. Chen Silvia D. Chang Mollie Carruthers |
author_sort |
Veronika Boyeva |
title |
Use of rituximab in idiopathic retroperitoneal fibrosis |
title_short |
Use of rituximab in idiopathic retroperitoneal fibrosis |
title_full |
Use of rituximab in idiopathic retroperitoneal fibrosis |
title_fullStr |
Use of rituximab in idiopathic retroperitoneal fibrosis |
title_full_unstemmed |
Use of rituximab in idiopathic retroperitoneal fibrosis |
title_sort |
use of rituximab in idiopathic retroperitoneal fibrosis |
publisher |
BMC |
series |
BMC Rheumatology |
issn |
2520-1026 |
publishDate |
2020-08-01 |
description |
Abstract Background Retroperitoneal fibrosis (RPF) is characterized by the proliferation of fibrous tissue in the retroperitoneum. The majority of RPF cases are due to idiopathic or IgG4-related disease. Recent studies on IgG4-related disease have shown rituximab to be an effective treatment. The current first-line treatment for idiopathic RPF (iRPF) is glucocorticoid therapy. Relapse rates vary widely in the literature, and DMARDs remain poorly studied. We sought to evaluate the efficacy of rituximab in idiopathic RPF by quantifying changes in iRPF diameter on imaging pre- and post-rituximab therapy and response by lab parameters in 10 iRPF patients. Methods We selected 10 patients diagnosed with iRPF and previously treated with rituximab (1000 mg) in two doses approximately 2 weeks apart. Pre- and post-therapy contrast enhanced cross-sectional abdomen and pelvis imaging were compared. In all patients, the thickest portion of the peri-aortic disease was measured in the axial and coronal planes. The presence of acute or long standing back pressure related renal findings were documented. Details of clinical visits including patient demographics and laboratory evaluations were collected pre- and post-therapy. Statistical analysis was performed using a Wilcoxon signed rank test. Results The RPF diameter around the aorta before and after therapy decreased from a mean of 15.9 ± 4.9 mm to 10.6 ± 6.1 mm, respectively (p < 0.01). The craniocaudal iRPF mean length decreased from 108.6 mm ± 40.4 mm to 90.6 mm ± 45.9 mm (p = 0.02). Conclusion A comparison of pre and post-rituximab imaging studies revealed a statistically significant decrease in iRPF diameter following treatment with rituximab. |
topic |
iRPF RPF RTX IgG4 |
url |
http://link.springer.com/article/10.1186/s41927-020-00140-9 |
work_keys_str_mv |
AT veronikaboyeva useofrituximabinidiopathicretroperitonealfibrosis AT hatimalabsi useofrituximabinidiopathicretroperitonealfibrosis AT michaelaseidman useofrituximabinidiopathicretroperitonealfibrosis AT ryanpaterson useofrituximabinidiopathicretroperitonealfibrosis AT jasonkur useofrituximabinidiopathicretroperitonealfibrosis AT lukeycchen useofrituximabinidiopathicretroperitonealfibrosis AT silviadchang useofrituximabinidiopathicretroperitonealfibrosis AT molliecarruthers useofrituximabinidiopathicretroperitonealfibrosis |
_version_ |
1724570925287866368 |