Rituximab-induced Regression of CREST-related Calcinosis

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2012 Nov 27

PMID 23179007

Citations 12

Authors

Dayane Raquel de Paula

Fabiane Barbero Klem

Pedro Gabriel Lorencetti

Carolina Muller

Valderilio Feijo Azevedo

Affiliations

Soon will be listed here.

Abstract

About a quarter of sclerodermic patients present calcinosis. However, patients with limited form of the disease are more likely to have calcinosis than patients with diffuse form. We report a case of a 54-year-old female patient with limited cutaneous scleroderma using rituximab (RTX) to treat lung fibrosis and arthritis. Into RTX treatment, she also had a complete resolution of calcinosis in her hands. The patient reported improvement in dyspnea and synovitis after two courses of RTX (four weekly infusions 375 mg/m(2) each). After 7 months of the first infusion, the calcinosis in her fingers had a complete remission, especially the right thumb. Based on current evidences, we discuss the use of rituximab as a promising therapy to treat not only lung disease but also calcinosis in patients with scleroderma.

Citing Articles

Ectopic calcifications in the musculoskeletal field: the basis for preventive and curative pharmacological strategies.

Milovanovic P, Savic I, Popovic A, Grajic M Clin Rheumatol. 2025; 44(3):869-886.

PMID: 39853559 DOI: 10.1007/s10067-025-07335-w.

Calcinosis Prevalence in Autoimmune Connective Tissue Diseases-A Retrospective Study.

Robert L, Nemeth K, Marschalko M, Hollo P, Hidvegi B J Clin Med. 2024; 13(12).

PMID: 38929957 PMC: 11204081. DOI: 10.3390/jcm13123428.

Treatment of calcinosis cutis associated with autoimmune connective tissue diseases.

Lau C, Smith G Arch Dermatol Res. 2024; 316(7):390.

PMID: 38878086 DOI: 10.1007/s00403-024-03148-0.

Systemic Sodium Thiosulfate as an Adjunct Treatment in Calcinosis: A Retrospective Study.

Robert L, Banvolgyi A, Lorincz K, Hollo P, Hidvegi B J Clin Med. 2023; 12(24).

PMID: 38137810 PMC: 10743828. DOI: 10.3390/jcm12247741.

Calcinosis Cutis and Calciphylaxis in Autoimmune Connective Tissue Diseases.

Mormile I, Mosella F, Turco P, Napolitano F, De Paulis A, Rossi F Vaccines (Basel). 2023; 11(5).

PMID: 37243003 PMC: 10222774. DOI: 10.3390/vaccines11050898.

References

Haroon M, McLaughlin P, Henry M, Harney S . Cyclophosphamide-refractory scleroderma-associated interstitial lung disease: remarkable clinical and radiological response to a single course of rituximab combined with high-dose corticosteroids. Ther Adv Respir Dis. 2011; 5(5):299-304. DOI: 10.1177/1753465811407786. View

Reiter N, El-Shabrawi L, Leinweber B, Berghold A, Aberer E . Calcinosis cutis: part II. Treatment options. J Am Acad Dermatol. 2011; 65(1):15-22. DOI: 10.1016/j.jaad.2010.08.039. View

Daoussis D, Liossis S, Yiannopoulos G, Andonopoulos A . B-cell depletion therapy in systemic sclerosis: experimental rationale and update on clinical evidence. Int J Rheumatol. 2011; 2011:214013. PMC: 3150146. DOI: 10.1155/2011/214013. View

McGonagle D, Tan A, Madden J, Rawstron A, Rehman A, Emery P . Successful treatment of resistant scleroderma-associated interstitial lung disease with rituximab. Rheumatology (Oxford). 2008; 47(4):552-3. DOI: 10.1093/rheumatology/kem357. View

Bader-Meunier B, Decaluwe H, Barnerias C, Gherardi R, Quartier P, Faye A . Safety and efficacy of rituximab in severe juvenile dermatomyositis: results from 9 patients from the French Autoimmunity and Rituximab registry. J Rheumatol. 2011; 38(7):1436-40. DOI: 10.3899/jrheum.101321. View

Boulman N, Slobodin G, Rozenbaum M, Rosner I . Calcinosis in rheumatic diseases. Semin Arthritis Rheum. 2005; 34(6):805-12. DOI: 10.1016/j.semarthrit.2005.01.016. View

Tashkin D, Elashoff R, Clements P, Goldin J, Roth M, Furst D . Cyclophosphamide versus placebo in scleroderma lung disease. N Engl J Med. 2006; 354(25):2655-66. DOI: 10.1056/NEJMoa055120. View

Edouard S, Sailler L, Sagot C, Munsch C, Astudillo L, Arlet P . [A painful thumb]. Rev Med Interne. 2010; 31(10):712-3. DOI: 10.1016/j.revmed.2009.12.015. View

Daoussis D, Antonopoulos I, Liossis S, Yiannopoulos G, Andonopoulos A . Treatment of systemic sclerosis-associated calcinosis: a case report of rituximab-induced regression of CREST-related calcinosis and review of the literature. Semin Arthritis Rheum. 2012; 41(6):822-9. DOI: 10.1016/j.semarthrit.2011.11.007. View

10.

Chiu Y, Co D . Juvenile dermatomyositis: immunopathogenesis, role of myositis-specific autoantibodies, and review of rituximab use. Pediatr Dermatol. 2011; 28(4):357-67. DOI: 10.1111/j.1525-1470.2011.01501.x. View

11.

Slimani S, Abdessemed A, Haddouche A, Ladjouze-Rezig A . Complete resolution of universal calcinosis in a patient with juvenile dermatomyositis using pamidronate. Joint Bone Spine. 2009; 77(1):70-2. DOI: 10.1016/j.jbspin.2009.04.011. View

12.

Lafyatis R, Kissin E, York M, Farina G, Viger K, Fritzler M . B cell depletion with rituximab in patients with diffuse cutaneous systemic sclerosis. Arthritis Rheum. 2009; 60(2):578-83. PMC: 2637937. DOI: 10.1002/art.24249. View

13.

Robertson L, Marshall R, Hickling P . Treatment of cutaneous calcinosis in limited systemic sclerosis with minocycline. Ann Rheum Dis. 2003; 62(3):267-9. PMC: 1754479. DOI: 10.1136/ard.62.3.267. View

14.

Daoussis D, Liossis S, Tsamandas A, Kalogeropoulou C, Kazantzi A, Sirinian C . Experience with rituximab in scleroderma: results from a 1-year, proof-of-principle study. Rheumatology (Oxford). 2009; 49(2):271-80. PMC: 2806066. DOI: 10.1093/rheumatology/kep093. View