[Rituximab immunomonitoring in autoimmune diseases: a support tool in clinical practice?]

Area of Science:

• Immunology
• Pharmacology
• Autoimmune Diseases

Background:

• Immune monitoring of monoclonal antibodies aids TNF blocker management in gastroenterology.
• Limited studies exist on monitoring other monoclonal antibodies like rituximab in autoimmune diseases.
• Rituximab has been widely used in autoimmune diseases for nearly 15 years.

Purpose of the Study:

• To describe clinical and biological characteristics of patients undergoing rituximab immune monitoring.
• To evaluate the utility of immune monitoring for rituximab in autoimmune conditions.

Main Methods:

• Retrospective review of clinical, biological, and therapeutic data for rituximab immune monitoring (2015 onwards).
• Measurement of rituximab serum levels and anti-rituximab antibodies using LISA-TRACKER Duo Rituximab®.
• Inclusion of suspected hypersensitivity and secondary non-response cases.

Main Results:

• 18 records analyzed from various specialties (nephrology, hematology, neurology, rheumatology, internal medicine).
• 10 cases of suspected hypersensitivity and 8 of secondary non-response were included.
• Anti-rituximab antibodies were detected in all 6 patients with serum sickness and half of secondary non-responders.

Conclusions:

• Rituximab immune monitoring, particularly anti-rituximab antibodies, shows potential benefits in autoimmune diseases.
• Monitoring is suggested for suspected serum sickness and secondary non-response (indicated by B-cell non-depletion).
• Larger, disease-specific studies are needed to confirm these findings.