Rituximab Treatment for Persistent Scleritis Associated with Rheumatoid Arthritis

Purpose: To report a clinical case of a patient with severe scleritis associated with rheumatoid arthritis (RA) refractive to conventional treatment that was treated effectively with rituximab. Methods and Results: A 55-year-old man with RA, on etanercept and oral methotrexate, was referred with dia...

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Bibliographic Details
Published in:Ocular immunology and inflammation 2010-06, Vol.18 (3), p.223-225
Main Authors: Iaccheri, Barbara, Androudi, Sofia, Bocci, Elena Bartoloni, Gerli, Roberto, Cagini, Carlo, Fiore, Tito
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal, Murine-Derived - administration & dosage
Antibodies, Monoclonal, Murine-Derived - therapeutic use
Antirheumatic Agents - administration & dosage
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - complications
Dose-Response Relationship, Drug
Humans
Infusions, Intravenous
Male
Middle Aged
Remission Induction
rheumatoid arthritis
Rituximab
scleritis
Scleritis - drug therapy
Scleritis - etiology
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Summary:Purpose: To report a clinical case of a patient with severe scleritis associated with rheumatoid arthritis (RA) refractive to conventional treatment that was treated effectively with rituximab. Methods and Results: A 55-year-old man with RA, on etanercept and oral methotrexate, was referred with diagnosis of acute stromal keratitis, anterior uveitis, and anterior nodular scleritis in his right eye. Cyclophosphamide induced complete regression of acute stromal keratitis and anterior uveitis, but scleritis was still active and persistent. After two 1000-mg infusions of rituximab, scleritis regressed completely and is still in remission 9 months after the second rituximab infusion, without any concomitant use of oral steroids. Conclusion: Rituximab may be a treatment alternative in severe scleritis that is refractive to conventional therapy. Considering its safety profile, further studies are needed to refine its mechanism of action, optimal indications, and dosing in ocular inflammation.
ISSN:0927-3948
1744-5078
DOI:10.3109/09273941003739928