Rituximab in Refractory Chronic Spontaneous Urticaria: An Encouraging Therapeutic Approach

Skin Pharmacol Physiol. 2018;31(4):184-187. doi: 10.1159/000487402. Epub 2018 Apr 12.

Abstract

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.

Keywords: Chronic spontaneous urticaria; Omalizumab; Rituximab; Urticaria.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoantibodies / immunology
  • Chronic Disease
  • Female
  • Humans
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use*
  • Rituximab / pharmacology
  • Rituximab / therapeutic use*
  • Treatment Outcome
  • Urticaria / drug therapy*
  • Urticaria / immunology

Substances

  • Autoantibodies
  • Immunologic Factors
  • Rituximab