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Long-Term Follow-Up of Patients with Scleritis After Rituximab Treatment Including B Cell Monitoring
Kiki van Bilsen1,2, Daphne P C Vergouwen2,3, Mirjam E J van Velthoven4
1Department of Internal Medicine, Section Clinical Immunology Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Purpose:
We report the long-term effect of rituximab (RTX) in scleritis and determine the value of B-cell monitoring for the prediction of relapses.
Methods:
We retrospectively studied 10 patients with scleritis, who were treated with RTX. Clinical characteristics were collected, and blood B-cell counts were measured before the start of RTX, and at various time points after treatment.
Results:
Clinical activity of scleritis decreased after RTX treatment in all patients within a median time of 8 weeks (range 3-13), and all reached remission. The median follow-up was 101 months (range 9-138). Relapses occurred in 6 out of 10 patients. All relapses, where B-cell counts were measured (11 out of 19), were heralded by returning B cells. However, B cells also returned in patients with long-term remissions.
Conclusions:
RTX is a promising therapeutic option for scleritis. Recurrence of B cells after initial depletion does not always predict relapse of scleritis.
