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Biological therapy in rheumatoid vasculitis: a systematic review
Débora Patrícia Alves de Cerqueira1, Ana Luisa Souza Pedreira2,3, Marcelo Gomes de Cerqueira4
1Escola Bahiana de Medicina e Saúde Pública, Av Dom João VI, 275 - Brotas, Salvador, BA, 40290-000, Brazil.
Clinical Rheumatology
|October 15, 2020
Summary
Biological therapies like rituximab and anti-TNF agents show promise for treating rheumatoid vasculitis, a severe rheumatoid arthritis complication. These treatments improved patient outcomes and achieved remission in nearly 70% of cases, despite a 34% adverse effect rate.
Area of Science:
- Rheumatology
- Immunology
- Clinical Medicine
Background:
- Rheumatoid vasculitis (RV) is a severe extra-articular manifestation of rheumatoid arthritis.
- It is associated with significant morbidity and mortality, often requiring aggressive treatment.
- Biological drugs represent a newer therapeutic option for RV.
Purpose of the Study:
- To systematically review the efficacy and safety of biological drugs in treating rheumatoid vasculitis.
- To evaluate the impact of biological therapies on clinical outcomes and corticosteroid use.
Main Methods:
- A systematic literature review adhering to PRISMA guidelines was conducted.
- Searches were performed across multiple electronic databases (MEDLINE/PubMed, Cochrane, SciELO, Scopus, VHL).
- Methodological quality was assessed using STROBE criteria.
Main Results:
- Five studies involving 35 patients were included, with treatments including rituximab, infliximab, and etanercept.
- Significant clinical improvement, reduced corticosteroid dosage, and improved Birmingham Vasculitis Activity Score were observed.
- Complete remission was achieved in nearly 70% of patients; adverse events occurred in 34%, primarily infections.
Conclusions:
- Biological therapy, including rituximab and anti-tumor necrosis factor agents, appears beneficial for managing rheumatoid vasculitis.
- These therapies can lead to significant clinical improvement and remission.
- Careful monitoring for adverse events, particularly infections, is crucial during treatment.
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