1887
Volume 2022, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Rituximab is used as second-line therapy in patients with immune thrombocytopenic purpura (ITP) who do not respond to first-line management. The response rate for Rituximab is variable in different populations ranging from 30% to 90%. The adverse effects of rituximab in patients with ITP range from infusion site reactions to the reactivation of hepatitis B virus and progressive multifocal leukoencephalopathy and interpopulation variation.

Methods: We conducted a single-center, retrospective study in Qatar's National Center for Cancer Care & Research. The study included patients with chronic refractory ITP who received rituximab as second-line therapy. Descriptive and summary statistics were used to describe the sociodemographic parameters of the study cohort.

Results: Of the 41 patients with chronic ITP, 26 were Arabs, 12 were Asians, and 3 were of other ethnicities. Rituximab was associated with an overall response rate of 80.4%. Arabic patients had the highest clinical response (84.6%) among the ethnicities with the lowest adverse effects (11.5%). Asians had a response rate of 66.6%, and adverse effects were seen in 16.7% of the patients.

Conclusions: In chronic refractory ITP, rituximab appears to have a better clinical response in the Arabic population with minimal toxicity than in other ethnicities.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2022.22
2022-07-07
2022-09-29
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2022/3/qmj.2022.22.html?itemId=/content/journals/10.5339/qmj.2022.22&mimeType=html&fmt=ahah

References

  1. Fogarty PF, Segal JB. The epidemiology of immune thrombocytopenic purpura. Current Opinion in Hematology. 14:(2:)515-9.
    [Google Scholar]
  2. Arnold DM. Immune thrombocytopenic: getting back to basics. American journal of hematology. 87:(2:)841-2.
    [Google Scholar]
  3. Zufferey A, Kapur R, Semple JW. Pathogenesis and Therapeutic Mechanisms in Immune Thrombocytopenia (ITP). J Clin Med. 6:(2).
    [Google Scholar]
  4. Mikulska M, Lanini S, Gudiol C, Drgona L, Ippolito G, Fernández-Ruiz M, et al. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Agents targeting lymphoid cells surface antigens [I]: CD19, CD20 and CD52). Clin Microbiol Infect. 24: Suppl 2:S71-s82.
    [Google Scholar]
  5. Provan D, Arnold DM, Bussel JB, Chong BH, Cooper N, Gernsheimer T, et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenic. Blood Adv. 3:(2:)3780-817.
    [Google Scholar]
  6. Chugh S, Darvish-Kazem S, Lim W, Crowther MA, Ghanima W, Wang G, et al. Rituximab plus standard of care for treatment of primary immune thrombocytopenic: a systematic review and meta-analysis. Lancet Haematol. 2:(2:)e75-81.
    [Google Scholar]
  7. Song F, Al-Samkari H. Management of Adult Patients with Immune Thrombocytopenia (ITP): A Review on Current Guidance and Experience from Clinical Practice. J Blood Med. 12:653-64.
    [Google Scholar]
  8. Arnold DM, Dentali F, Crowther MA, Meyer RM, Cook RJ, Sigouin C, et al. Systematic review: efficacy and safety of rituximab for adults with idiopathic thrombocytopenic purpura. Ann Intern Med. 146:(2:)25-33.
    [Google Scholar]
  9. Miyakawa Y, Katsutani S, Yano T, Nomura S, Nishiwaki K, Tomiyama Y, et al. Efficacy and safety of rituximab in Japanese patients with relapsed chronic immune thrombocytopenic refractory to conventional therapy. Int J Hematol. 102:(2:)654-61.
    [Google Scholar]
  10. Alasfoor K, Alrasheed M, Alsayegh F, Mousa SA. Rituximab in the treatment of idiopathic thrombocytopenic purpura (ITP). Ann Hematol. 88:(2:)239-43.
    [Google Scholar]
  11. Godeau B, Porcher R, Fain O, Lefrère F, Fenaux P, Cheze S, et al. Rituximab efficacy and safety in adult splenectomy candidates with chronic immune thrombocytopenic purpura: results of a prospective multicenter phase 2 study. Blood. 112:(2:)999-1004.
    [Google Scholar]
  12. Stasi R, Pagano A, Stipa E, Amadori S. Rituximab chimeric anti-CD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura. Blood. 98:(2:)952-7.
    [Google Scholar]
  13. The jamovi project (2020). jamovi (Version 1.2) [Computer Software] 2020 [Available from: https://www.jamovi.org.
    [Google Scholar]
  14. Khellaf M, Charles-Nelson A, Fain O, Terriou L, Viallard JF, Cheze S, et al. Safety and efficacy of rituximab in adult immune thrombocytopenic: results from a prospective registry including 248 patients. Blood. 124:(2:)3228-36.
    [Google Scholar]
  15. Burroughs VJ, Maxey RW, Levy RA. Racial and ethnic differences in response to medicines: towards individualized pharmaceutical treatment. J Natl Med Assoc. 94:(10 Suppl):1-26.
    [Google Scholar]
  16. Hunt S. Pharmacogenetics, Personalized Medicine, and Race. Nature Education. 1:(2:)212.
    [Google Scholar]
  17. Kim TO, Grimes AB, Kirk SE, Gilbert MM, Reed HD, Staggers KA, et al. Racial variation in ITP prevalence and chronic disease phenotype suggests biological differences. Blood. 136:(2:)640-3.
    [Google Scholar]
  18. Vicente AM, Ballensiefen W, Jönsson J-I. How personalised medicine will transform healthcare by 2030: the ICPerMed vision. Journal of Translational Medicine. 18:(2:)180.
    [Google Scholar]
  19. Zhong M, van der Walt A, Campagna MP, Stankovich J, Butzkueven H, Jokubaitis V. The Pharmacogenetics of Rituximab: Potential Implications for Anti-CD20 Therapies in Multiple Sclerosis. Neurotherapeutics. 17:(2:)1768-84.
    [Google Scholar]
  20. Cooper N, Stasi R, Cunningham-Rundles S, Feuerstein MA, Leonard JP, Amadori S, et al. The efficacy and safety of B-cell depletion with anti-CD20 monoclonal antibody in adults with chronic immune thrombocytopenic purpura. British Journal of Haematology. 125:(2:)232-9.
    [Google Scholar]
  21. Giagounidis AA, Anhuf J, Schneider P, Germing U, Söhngen D, Quabeck K, et al. Treatment of relapsed idiopathic thrombocytopenic purpura with the anti-CD20 monoclonal antibody rituximab: a pilot study. Eur J Haematol. 69:(2:)95-100.
    [Google Scholar]
  22. Deshayes S, Khellaf M, Zarour A, Layese R, Fain O, Terriou L, et al. Long-term safety and efficacy of rituximab in 248 adults with immune thrombocytopenic: Results at 5?years from the French prospective registry ITP-ritux. Am J Hematol. 94:(2:)1314-24.
    [Google Scholar]
  23. Comparison of propranolol and hydrochlorothiazide for the initial treatment of hypertension. II. Results of long-term therapy. Veterans Administration Cooperative Study Group on Antihypertensive Agents. Jama. 248:(2:)2004-11.
    [Google Scholar]
  24. Johnson JA. Ethnic differences in cardiovascular drug response: potential contribution of pharmacogenetics. Circulation. 118:(2:)1383-93.
    [Google Scholar]
  25. Cazzola M, Rogliani P, Sanduzzi A, Matera MG. Influence of ethnicity on response to asthma drugs. Expert Opin Drug Metab Toxicol. 11:(2:)1089-97.
    [Google Scholar]
  26. Emsley RA, Roberts MC, Rataemane S, Pretorius J, Oosthuizen PP, Turner J, et al. Ethnicity and treatment response in schizophrenia: a comparison of 3 ethnic groups. J Clin Psychiatry. 63:(2:)9-14.
    [Google Scholar]
  27. Lesser IM, Zisook S, Gaynes BN, Wisniewski SR, Luther JF, Fava M, et al. Effects of race and ethnicity on depression treatment outcomes: the CO-MED trial. Psychiatr Serv. 62:(2:)1167-79.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/qmj.2022.22
Loading
/content/journals/10.5339/qmj.2022.22
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): EthnicityImmune thrombocytopenic purpuraITP and Rituximab
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error