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Open Access 28-09-2022 | Vasculitis | Review Article

Management of mixed cryoglobulinemia with rituximab: evidence and consensus-based recommendations from the Italian Study Group of Cryoglobulinemia (GISC)

Authors: Luca Quartuccio, Alessandra Bortoluzzi, Carlo Alberto Scirè, Antonio Marangoni, Giulia Del Frate, Elena Treppo, Laura Castelnovo, Francesco Saccardo, Roberta Zani, Marco Candela, Paolo Fraticelli, Cesare Mazzaro, Piero Renoldi, Patrizia Scaini, Davide Antonio Filippini, Marcella Visentini, Salvatore Scarpato, Dilia Giuggioli, Maria Teresa Mascia, Marco Sebastiani, Anna Linda Zignego, Gianfranco Lauletta, Massimo Fiorilli, Milvia Casato, Clodoveo Ferri, Maurizio Pietrogrande, Pietro Enrico Pioltelli, Salvatore De Vita, Giuseppe Monti, Massimo Galli

Published in: Clinical Rheumatology | Issue 2/2023

Abstract

Cryoglobulinemic vasculitis (CV) or mixed cryoglobulinemic syndrome (MCS) is a systemic small-vessel vasculitis characterized by the proliferation of B-cell clones producing pathogenic immune complexes, called cryoglobulins. It is often secondary to hepatitis C virus (HCV), autoimmune diseases, and hematological malignancies. CV usually has a mild benign clinical course, but severe organ damage and life-threatening manifestations can occur. Recently, evidence in favor of rituximab (RTX), an anti-CD 20 monoclonal antibody, is emerging in CV: nevertheless, questions upon the safety of this therapeutic approach, especially in HCV patients, are still being issued and universally accepted recommendations that can help physicians in MCS treatment are lacking. A Consensus Committee provided a prioritized list of research questions to perform a systematic literature review (SLR). A search was made in Medline, Embase, and Cochrane library, updated to August 2021. Of 1227 article abstracts evaluated, 27 studies were included in the SLR, of which one SLR, 4 RCTs, and 22 observational studies. Seventeen recommendations for the management of mixed cryoglobulinemia with rituximab from the Italian Study Group of Cryoglobulinemia (GISC) were developed to give a valuable tool to the physician approaching RTX treatment in CV.

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Title: Management of mixed cryoglobulinemia with rituximab: evidence and consensus-based recommendations from the Italian Study Group of Cryoglobulinemia (GISC)
Authors: Luca Quartuccio
Alessandra Bortoluzzi
Carlo Alberto Scirè
Antonio Marangoni
Giulia Del Frate
Elena Treppo
Laura Castelnovo
Francesco Saccardo
Roberta Zani
Marco Candela
Paolo Fraticelli
Cesare Mazzaro
Piero Renoldi
Patrizia Scaini
Davide Antonio Filippini
Marcella Visentini
Salvatore Scarpato
Dilia Giuggioli
Maria Teresa Mascia
Marco Sebastiani
Anna Linda Zignego
Gianfranco Lauletta
Massimo Fiorilli
Milvia Casato
Clodoveo Ferri
Maurizio Pietrogrande
Pietro Enrico Pioltelli
Salvatore De Vita
Giuseppe Monti
Massimo Galli
Publication date: 28-09-2022
Publisher: Springer International Publishing
Keywords: Vasculitis
Vasculitis
Rituximab
Hepatitis C
Rituximab
Published in: Clinical Rheumatology / Issue 2/2023
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-022-06391-w

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