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Published on: June 7, 2017
Sjögren keratoconjunctivitis sicca treated with rituximab
Luis Fernando Zapata1, Luz Marina Agudelo, Jose David Paulo
1Ophthalmology. Corneal and Refractive Surgery Department, Clínica Universitaria Bolivariana, Medellin, Colombia. luiszg70@hotmail.com
Cornea
|August 2, 2007
Summary
Rituximab, a B-lymphocyte depleting therapy, significantly improved severe dry eye disease (keratoconjunctivitis sicca) in two patients unresponsive to standard treatments. This suggests rituximab may be a viable option for refractory Sjögren syndrome cases.
Area of Science:
- Ophthalmology
- Immunology
- Rheumatology
Background:
- Severe keratoconjunctivitis sicca, often associated with Sjögren syndrome, presents a therapeutic challenge when conventional treatments fail.
- B lymphocytes are implicated in the pathogenesis of Sjögren syndrome, suggesting targeted B-cell depletion as a potential treatment strategy.
Observation:
- Two patients with refractory severe dry eye disease secondary to Sjögren syndrome were treated with rituximab.
- Rituximab, a chimeric monoclonal antibody targeting CD20 on B cells, was administered to assess its efficacy and safety.
Findings:
- Both patients experienced marked improvement in keratoconjunctivitis sicca, including enhanced Schirmer test values, tear film breakup time, visual acuity, and reduced symptomatology.
- Systemic manifestations of Sjögren syndrome also improved, leading to a better quality of life for the patients.
- Rituximab demonstrated a secure safety profile, consistent with its use in other autoimmune conditions and cancers.
Implications:
- Rituximab shows promise as an effective treatment for refractory cases of keratoconjunctivitis sicca in Sjögren syndrome.
- These findings support the role of B cells in the disease's pathogenesis and highlight rituximab's potential for immunoablation.
- Further investigation through multicenter, randomized, placebo-controlled clinical trials is warranted to confirm these observations.
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