Rituximab in the treatment of thyroid eye disease: Science fiction?

Mario Salvi, Guia Vannucchi, Irene Campi, Paolo Beck-Peccoz

Research output: Contribution to journalArticle

Abstract

Lately, monoclonal antibodies directed to molecules of the immune system have become available. Rituximab (RTX) is a humanized chimeric anti-CD20 monoclonal antibody which blocks the activation and differentiation of B cells. The rationale for use in Graves' disease (GD) and orbitopathy is the potential effect on B-cell mediated immunity. Transient B cell depletion may modify the active inflammatory phase of thyroid eye disease (TED). We have studied nine patients with GD, of whom seven had active TED and two only lid signs. All but one patients showed both CD20 cells and CD19 cells depletion with the first RTX infusion, while one had persistent 3-5% CD19 cells. RTX was well tolerated and only minor side effects were reported in three patients at first infusion. Circulating antithyroglobulin, antithyroperoxidase and anti-TSH receptor antibodies did not change significantly and did not correlate to CD20 depletion. The clinical activity score value was 4.7±0.5 before therapy and 1.8±0.8 at the end of follow-up (P

Original languageEnglish
Pages (from-to)251-255
Number of pages5
JournalOrbit
Volume28
Issue number4
DOIs
Publication statusPublished - 2009

Keywords

  • Corticosteroids
  • Graves orbitopathy
  • Immunosuppression
  • Rituximab

ASJC Scopus subject areas

  • Ophthalmology

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