A randomized controlled trial of rituximab following failure of antiviral therapy for hepatitis C virus-associated cryoglobulinemic vasculitis

Arthritis Rheum. 2012 Mar;64(3):835-42. doi: 10.1002/art.34322.


Objective: To perform a randomized controlled trial of rituximab in patients with hepatitis C virus (HCV)-associated mixed cryoglobulinemic vasculitis.

Methods: We conducted a single-center, open-label, randomized controlled trial of rituximab (375 mg/ m(2) /week for 4 weeks) compared to the best available therapy (maintenance or increase in immunosuppressive therapy) for HCV-associated cryoglobulinemic vasculitis in patients in whom antiviral therapy had failed to induce remission. The primary end point was disease remission at 6 months from study entry.

Results: A total of 24 patients were enrolled (12 in each treatment group). Baseline disease activity and organ involvement were similar in the two groups. Ten patients in the rituximab group (83%) were in remission at study month 6, as compared with 1 patient in the control group (8%), a result that met the criterion for stopping the study (P < 0.001). The median duration of remission for rituximab-treated patients who reached the primary end point was 7 months. No adverse effects of rituximab on HCV plasma viremia or on hepatic transaminase levels were observed.

Conclusion: Rituximab was a well-tolerated and effective treatment in patients with HCV-associated cryoglobulinemic vasculitis in whom antiviral therapy failed to induce remission.

Trial registration: ClinicalTrials.gov NCT00029107.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Intramural

MeSH terms

  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Antiviral Agents / therapeutic use*
  • Cryoglobulinemia / complications
  • Cryoglobulinemia / drug therapy*
  • Drug Resistance, Viral / drug effects*
  • Female
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Immunologic Factors / therapeutic use*
  • Male
  • Middle Aged
  • Remission Induction
  • Rituximab
  • Treatment Outcome


  • Antibodies, Monoclonal, Murine-Derived
  • Antiviral Agents
  • Immunologic Factors
  • Rituximab

Associated data

  • ClinicalTrials.gov/NCT00029107