Rituximab in the Treatment of Refractory Noninfectious Scleritis

Abstract

We read with interest the article “Rituximab in the Treatment of Refractory Noninfectious Scleritis” by Cao and associates. 1 Cao J.H. Oray M. Cocho L. Foster C.S. Rituximab in the treatment of refractory noninfectious scleritis. Am J Ophthalmol. 2016; 164: 22-28 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar In conjunction with our recently published experience with rituximab (RTX) on scleritis secondary to granulomatosis with polyangiitis (GPA), 2 Recillas-Gispert C. Serna-Ojeda J.C. Flores-Suárez L.F. Rituximab in the treatment of refractory scleritis in patients with granulomatosis with polyangiitis (Wegener's). Graefes Arch Clin Exp Ophthalmol. 2015; 253: 2279-2284 Crossref PubMed Scopus (24) Google Scholar in which we observed similar results in 8 patients, we think it valuably adds to RTX use in such conditions, especially as per their primary outcome measure. Nonetheless, it is common practice to observe glucocorticoid (GC) dependence, with short-term independence of these drugs. Therefore, their goal seems ambitious and we would inquire if consideration was given to maintaining low (≤10 mg) prednisone dose, as in other studies, 3 Suhler E.B. Lim L.L. Beardsley R.M. et al. Rituximab therapy for refractory scleritis: results of a phase I/II dose-ranging, randomized, clinical trial. Ophthalmology. 2014; 121: 1885-1891 Abstract Full Text Full Text PDF PubMed Scopus (66) Google Scholar instead of requiring maintenance with other immunosuppressants, as was the case in 13 of 15 patients, some prescribed in combination, with the use of RTX and cyclophosphamide in 2 patients, who, interestingly, were the only lost to follow-up. Linked to this, the authors did not state the mean or median doses of prednisone the patients received at time of RTX treatment. Rituximab in the Treatment of Refractory Noninfectious ScleritisAmerican Journal of OphthalmologyVol. 164PreviewTo describe the outcomes of the use of rituximab in the treatment of refractory noninfectious scleritis. Full-Text PDF Rituximab in the Treatment of Refractory Noninfectious ScleritisAmerican Journal of OphthalmologyVol. 166PreviewWe kindly thank Drs Serna-Ojeda and Flores-Suárez for their interest in our recent article, entitled “Rituximab in the Treatment of Refractory Noninfectious Scleritis.” We are encouraged by the positive response of their additional 8 patients to a similar therapy. Full-Text PDF