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Rituximab in Refractory Chronic Spontaneous Urticaria: An Encouraging Therapeutic Approach

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Published:31st May 2018

Author: Combalia A, Losno RA, Prieto-González S, Mascaró JM.

Source: Skin Pharmacology and Physiology

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Ref.:Skin Pharmacol Physiol.;31(4):184-187.

DOI:10.1159/000487402

Rituximab in Refractory Chronic Spontaneous Urticaria: An Encouraging Therapeutic Approach

Background: Chronic spontaneous urticaria (CSU) is a frequent mast cell-driven disease that affects approximately 0.5-1% of the population. Antihistamines are currently the drugs of choice in patients with CSU. Omalizumab has been shown to be very effective in CSU and has been recently approved as second-line therapy. However, although its introduction has markedly improved the therapeutic possibilities for CSU, there is still a hard core of patients who do not respond and require effective treatment.

Methods: We report the case of a patient who achieved an 8-month remission of refractory CSU following the use of rituximab, and perform a review of the literature regarding the use of rituximab in CSU.

Results: There was a remarkable improvement in her CSU after the administration of rituximab maintained over time.

Conclusion: Rituximab is a chimeric murine/human monoclonal antibody directed against CD20, which depletes memory B-lymphocytes that are necessary for autoantibody production. The abrogation of the autoantibody production is the proposed mechanism by which it may alleviate the symptoms of CSU.

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