Journal article
Rituximab-induced serum sickness: A systematic review
Seminars in arthritis and rheumatism, v 45(3), pp 334-340
01 Dec 2015
PMID: 26199061
Abstract
Objectives: To report a case of rituximab-induced serum sickness (RISS) and perform a systematic review and characterize RISS in autoimmune diseases and hematological malignancies.
Methods: A comprehensive search of MEDLINE, EMBASE, ACR, and EULAR databases was performed for relevant articles of patients with RISS from inception to September 2014. Statistical analysis of demographic and clinical features was performed using Microsoft EXCEL 2007 and SPSS version 20.0.
Results: In the 33 patients with RISS, the mean age of presentation was 39.1 +/- 17.5 yr with a female preponderance (n = 23, 76.67%). The majority of cases were associated with an underlying rheumatologic condition (n = 17, 51.5%), most commonly Sjogren's syndrome (n = 8, 44.4%). The classic triad of serum sickness (fever, rash, and arthralgia) was reported in 16 (48.5%) cases. Time from drug exposure to symptom onset was significantly greater with the first doses of rituximab compared to the second dose (mean time 10.00 vs. 4.05 d, P = 0.002), and time to resolution was significantly greater for rheumatologic vs. hematological indications (mean time 2.50 vs. 1.00 d, P = 0.035). Corticosteroids were the most commonly used treatment (n = 21), with all cases reporting a complete resolution of symptoms in 2.15 +/- 1.34 d.
Conclusion: It is important to recognize RISS clinically, as it may mimic exacerbation of various rheumatologic conditions. Although RISS is typically self-limited, further infusions of rituximab should be avoided, as it may provoke more severe symptoms. (C) 2015 Elsevier Inc. All rights reserved.
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Details
- Title
- Rituximab-induced serum sickness: A systematic review
- Creators
- Paras Karmacharya (Corresponding Author) - Reading HospitalDilli Ram Poudel - Reading HospitalRanjan Pathak - Reading HospitalAnthony A. Donato - Reading HospitalSushil Ghimire - Reading HospitalSmith Giri - University of Tennessee Health Science CenterMadan Raj Aryal - Reading HospitalClifton O. Bingham - Johns Hopkins University
- Publication Details
- Seminars in arthritis and rheumatism, v 45(3), pp 334-340
- Publisher
- Elsevier
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate); General Internal Medicine
- Web of Science ID
- WOS:000369773800012
- Scopus ID
- 2-s2.0-84937141175
- Other Identifier
- 991022161839304721