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Rituximab in the Treatment of Refractory Dermatomyositis

Chiappetta, Nicole DO; Steier, James MD; Gruber, Barry MD

JCR: Journal of Clinical Rheumatology: October 2005 - Volume 11 - Issue 5 - p 264-266
doi: 10.1097/01.rhu.0000182155.08982.60
Case Report

Dermatomyositis is an inflammatory myopathy characterized by muscle weakness and inflammation. In contrast to polymyositis and inclusion body myositis, humoral immune mechanisms appear to contribute to the pathogenesis of dermatomyositis. A 56-year-old man with dermatomyositis resistant to conventional therapies was treated with 6 weekly infusions of the anti-CD-20 monoclonal antibody, rituximab, at a dosage of 100 mg/m2 in addition to other agents. The patient demonstrated a remarkable clinical response as indicated by an increase in muscle strength and a decline in creatine kinase enzymes. B-cell depletion therapy with rituximab used alone or in combination with other immunosuppressive therapies may be a viable option in patients with dermatomyositis as well as other autoimmune diseases refractory to current therapies.

Addition of rituximab to a complex therapeutic regimen seemed to be instrumental in improvement. JO-1 antibody titers did not change.

From the Department of Rheumatology, Stony Brook University Hospital, Stony Brook, New York.

Reprints: Nicole Chiappetta, DO, Department of Rheumatology, SUNY at Stony Brook, HSC-16 040, Stony Brook, NY 11794. E-mail: nhazlett@gmail.com.

© 2005 Lippincott Williams & Wilkins, Inc.