Efficacy and safety of rituximab in autoimmune pancreatitis type 1: our experiences and systematic review of the literature

Autoimmune pancreatitis (AIP) is a special form of pancreatitis that responds well to glucocorticoid (GC) treatment. Relapses of AIP are common. The anti-CD20 antibody rituximab (RTX) has shown promising results in GC refractory cases, but long-term data are scarce. The study aims to determine the c...

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Bibliographic Details
Published in:	Scandinavian journal of gastroenterology Vol. 56; no. 11; pp. 1355 - 1362
Main Authors:	Nikolic, Sara, Panic, Nikola, Hintikka, Elina Sofia, Dani, Lara, Rutkowski, Wiktor, Hedström, Aleksandra, Steiner, Corinna, Löhr, J.-Matthias, Vujasinovic, Miroslav
Format:	Journal Article
Language:	English
Published:	Taylor & Francis 02-11-2021
Subjects:	Autoimmune pancreatitis IgG4-related disease Medicin och hälsovetenskap relapse rituximab
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Summary:	Autoimmune pancreatitis (AIP) is a special form of pancreatitis that responds well to glucocorticoid (GC) treatment. Relapses of AIP are common. The anti-CD20 antibody rituximab (RTX) has shown promising results in GC refractory cases, but long-term data are scarce. The study aims to determine the clinical and imaging response to RTX and summarize the existing data on RTX therapy in patients with AIP type 1 in the literature. Retrospective analysis of electronic medical records was conducted. Additionally, we conducted a systematic review of the literature concerning RTX use in AIP type 1. Twelve (11.7%) of 103 patients with AIP type 1 were treated with RTX during the study period: eight (66.7%) achieved complete and four (33.3%) partial remission. RTX was discontinued in one patient who developed fever and reactivation of latent tuberculosis. None of the remaining 11 patients relapsed during a median follow-up of 17 months. No significant differences were detected in baseline clinical characteristics or history of relapse between the patients who obtained complete and partial remission. Altogether, eight studies with 110 AIP type-1 patients treated with RTX were analyzed. Adverse effects ranged from 11-43% and the relapse-free period during follow-up (range 2-173 months) ranged from 38-94%. Our results confirm that RTX is efficacious in the treatment of AIP type 1 by inducing remission and preventing relapse. In addition, there are few adverse effects of the treatment.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0036-5521 1502-7708 1502-7708
DOI:	10.1080/00365521.2021.1963837