Rituximab in the Treatment of Refractory Anti-HMGCR Immune-mediated Necrotizing Myopathy.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 30554155.
- Also identified by DOI 10.3899/jrheum.171495.
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Abstract
A pathogenic role of anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibodies has been proposed. Our objective was to assess efficacy of rituximab (RTX) in anti-HMGCR immune-mediated necrotizing myopathy. All patients who had been treated with RTX were retrospectively reviewed to assess features and outcome. Three of 9 patients demonstrated stable or improved muscle strength ± decline in creatine kinase levels, or T2/short-tau inversion recovery hypersignal decrease on magnetic resonance imaging following RTX treatment. RTX permitted intravenous immunoglobulin discontinuation and corticosteroid reduction to low dose in 2 patients. One-third of patients with refractory anti-HMGCR had improved strength or other evidence of improved disease activity following RTX treatment.
Medical subject headings
- Autoimmune Diseases
- Hydroxymethylglutaryl CoA Reductases
- Immunologic Factors
- Myositis
- Rituximab