| Autor: |
Covic A; Nephrology Department, Dialysis and Renal Transplant Center, 'Dr. C.I. Parhon' University Hospital, 700503 Iasi, Romania.; Faculty of Medicine, 'Grigore T. Popa' University of Medicine, 700115 Iasi, Romania., Caruntu ID; Faculty of Medicine, 'Grigore T. Popa' University of Medicine, 700115 Iasi, Romania.; Department of Morpho-Functional Sciences I-Histology, Pathology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania., Burlacu A; Faculty of Medicine, 'Grigore T. Popa' University of Medicine, 700115 Iasi, Romania.; Department of Interventional Cardiology, Cardiovascular Diseases Institute 'Prof. Dr. George I.M. Georgescu', 700503 Iasi, Romania., Giusca SE; Faculty of Medicine, 'Grigore T. Popa' University of Medicine, 700115 Iasi, Romania.; Department of Morpho-Functional Sciences I-Histology, Pathology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania., Covic A; Nephrology Department, Dialysis and Renal Transplant Center, 'Dr. C.I. Parhon' University Hospital, 700503 Iasi, Romania.; Faculty of Medicine, 'Grigore T. Popa' University of Medicine, 700115 Iasi, Romania., Stefan AE; Nephrology Department, Dialysis and Renal Transplant Center, 'Dr. C.I. Parhon' University Hospital, 700503 Iasi, Romania., Brinza C; Faculty of Medicine, 'Grigore T. Popa' University of Medicine, 700115 Iasi, Romania.; Department of Interventional Cardiology, Cardiovascular Diseases Institute 'Prof. Dr. George I.M. Georgescu', 700503 Iasi, Romania., Ismail G; Department of Nephrology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.; Department of Nephrology, Fundeni Clinical Institute, 022328 Bucharest, Romania. |
| Abstrakt: |
(1) Background. Hepatitis C infection often leads to extrahepatic manifestations, including cryoglobulinemic vasculitis. This systematic review aimed to assess the efficacy and safety of rituximab in treating hepatitis C-associated cryoglobulinemic vasculitis. (2) Methods. Following PRISMA guidelines, databases were searched for relevant studies. Eligibility criteria included studies on hepatitis C-associated cryoglobulinemic vasculitis treated with rituximab. (3) Results. Nine studies met the eligibility criteria and were included in this analysis. Rituximab was commonly administered at 375 mg/m 2 weekly for one month. The results consistently demonstrated the efficacy of rituximab, whether as a standalone treatment or as part of a therapeutic regimen. The combination of rituximab with Peg-IFN-α and ribavirin significantly increased the complete response rate compared to Peg-IFN-α and ribavirin alone (54.5% vs. 33.3%, p < 0.05). The 3-year sustained response rate was notably higher in the rituximab combination group (83.3% vs. 40%). In another trial, rituximab achieved remission in 83.3% of patients at 6 months, compared to only 8.3% in the control group. The efficacy of rituximab was supported by long-term experience, with clinical benefits in patients with severe cryoglobulinemic vasculitis, including those resistant to standard therapies. Mild adverse events were generally reported, with rare severe reactions in some studies. (4) Conclusions: In conclusion, rituximab appeared to be effective and safe in managing hepatitis C-associated cryoglobulinemic vasculitis, either alone or with antiviral therapy. |
