Table 1.
Characteristics of patients and efficacy of rituximab therapy by rheumatoid arthritis (RA) and secondary amyloid A (AA) amyloidosis.
| Patient 1 | Patient 2 | Patient 3 | Patient 4 | |
|---|---|---|---|---|
| Sex/Age (years) | F/56 | F/59 | F/48 | F/59 |
| First symptom of disease (years) | 22 | 44 | 6 | 31 |
| Disease duration (years) | 22 | 19 | 3 | 31 |
| Clinical manifestations | RF-PU | PU, RF | PU | RF-PU |
| Previous therapy/treatment | MTX, SSZ, HCQ, LEF, CS, ETA, ADM | MTX, SSZ, LEF, CS | MTX, SSZ, LEF, CS, ADM, ETA | MTX, SSZ, LEF, CS, ETA |
| Comorbidity | - | HT | - | HT, DM |
| Romatoid factor (IU/mI) (0–20) | Positive | Positive | Negative | Negative |
| CCP (U/mI) (0–20) | N/A | N/A | N/A | Negative |
| Site of biopsy for amyloidosis | Renal | Renal | Renal | Renal |
| Duration after the first dose of RTX (months) | 96 | 6 | 6 | 16 |
| Concomitant therapy (DMARDs) | LEF, CS | CS | LEF, CS | LEF, CS |
| Other treatment for proteinuria | Losartan, Colchicine | Ramipril, Colchicine | Colchicine | Colchicine |
| Number of courses of therapy (1 g RTX separated by a 2-week interval) | 16 | 1 | 1 | 3 |
| Articular response and biochemical outcomes | ||||
| Baseline (Before the rituximab therapy) | ||||
| DAS 28-ESR | 7.7 | 5.15 | 6.4 | 6.2 |
| ESR (mm/h) | 61 | 48 | 79 | 98 |
| CRP (mg/dL) | 6.5 | 0.54 | 3.81 | 1.69 |
| Serum creatinine (mg/dL) | 1.6 | 1.8 | 0.5 | 0.46 |
| Quantitative proteinuria (g/L in 24 h) | 4.8 | 4.5 | 2.4 | 0.5 |
| Last follow-up | ||||
| DAS 28-ESR | 4.49 | 6.28 | 3.47 | 5.2 |
| ESR (mm/h) | 13 | 61 | 15 | 87 |
| CRP (mg/dL) | 1.25 | 1.2 | 0.4 | 2.59 |
| Serum creatinine (mg/dL) | 1.56 | 1.93 | 0.7 | 6.8 |
| Quantitative proteinuria/(g/L in 24 h) | 0.4 | 0.3 | 2.3 | 15.5 |
| Efficacy for the underlying disease | + | Active disease | + | Active disease |
| Efficacy for renal involvement | Improvement | Improvement | Stabilization | Renal failure, haemodialysis |
| Adverse events | NAE | NAE | Recurrent infections | NAE |
| Pursuit of RTX at the end of the follow-up | + | Switch to ETA | Switch to TCZ | Switch to TCZ |
No adverse event; NAE, RF; rheumatoid factor, CCP; anti-cyclic citrullinated peptide, DAS-28; Disease Activity Score 28, ESR; sedimentation, CRP; C-reactive protein, RTX; rituximab, DMARDs; disease-modifying antirheumatic drugs, renal failure; RF, proteinuria; PU, HT; hypertension, DM; diabetes mellitus, SSZ; sulfasalazine, HCQ; hydroxychloroquine, LEF; leflunomide, CS; corticosteroids, ETA; etanercept, ADM; adalimumab, TCZ; tocilizumab, F; female.