Rituximab-induced hypogammaglobulinemia in patients affected by idiopathic inflammatory myopathies: a multicenter study

Edoardo Conticini, Miriana d’Alessandro, Silvia Grazzini, Chiara Rizzo, Marco Fornaro, Paolo Cameli, David Bennett, Anna Abbruzzese, Federica Camarda, Giuseppe Lopalco, Laura Bergantini, Paolo Falsetti, Elena Bargagli, Florenzo Iannone, Giuliana Guggino, Hector Chinoy, Luca Cantarini, Bruno Frediani

Research output: Contribution to journalArticlepeer-review


Background: Rituximab (RTX) is an anti-CD20 chimeric monoclonal antibody recommended as off- label treatment in patients with idiopathic inflammatory myopathies (IIM). The present study aimed to evaluate changes in immunoglobulin (Ig) levels during RTX-treatment and their potential association with infections in a cohort of IIM patients.
Materials and methods: Patients evaluated in the Myositis clinic belonging to the Rheumatology Units of Siena, Bari and Palermo University Hospitals, and treated for the first time with RTX were enrolled. Demographic, clinical, laboratory and treatment variables, including previous and concomitant immunosuppressive drugs and glucocorticoid dosage were analysed before (T0) and after 6 (T1) and 12 (T2) months of RTX treatment.
Results: Thirty patients (median age, IQR 56 (42-66); 22 female) were selected. During the observational period low levels of IgG (Conclusion: Hypogammaglobulinemia following RTX is uncommon in IIM and is not related to any clinical variables, including GCs dosage and previous treatments. IgG and IgM monitoring after RTX treatment does not seem useful in stratifying patients who require closer safety monitoring and prevention of infection, due to the lack of association between hypogammaglobulinemia and the onset of severe infections.
Original languageEnglish
JournalClinical and Experimental Rheumatology
Publication statusAccepted/In press - 16 Dec 2022


  • Rituximab
  • Myositis
  • hypogammaglobulinemia


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