%0 Systematic Review
%T Management of mixed cryoglobulinemia with rituximab: evidence and consensus-based recommendations from the Italian Study Group of Cryoglobulinemia (GISC).
%A Quartuccio L
%A Bortoluzzi A
%A Scirè CA
%A Marangoni A
%A Del Frate G
%A Treppo E
%A Castelnovo L
%A Saccardo F
%A Zani R
%A Candela M
%A Fraticelli P
%A Mazzaro C
%A Renoldi P
%A Scaini P
%A Filippini DA
%A Visentini M
%A Scarpato S
%A Giuggioli D
%A Mascia MT
%A Sebastiani M
%A Zignego AL
%A Lauletta G
%A Fiorilli M
%A Casato M
%A Ferri C
%A Pietrogrande M
%A Pioltelli PE
%A De Vita S
%A Monti G
%A Galli M
%J Clin Rheumatol
%V 42
%N 2
%D Feb 2023
%M 36169798
%F 3.65
%R 10.1007/s10067-022-06391-w
%X Cryoglobulinemic vasculitis (CV) or mixed cryoglobulinemic syndrome (MCS) is a systemic small-vessel vasculitis characterized by the proliferation of B-cell clones producing pathogenic immune complexes, called cryoglobulins. It is often secondary to hepatitis C virus (HCV), autoimmune diseases, and hematological malignancies. CV usually has a mild benign clinical course, but severe organ damage and life-threatening manifestations can occur. Recently, evidence in favor of rituximab (RTX), an anti-CD 20 monoclonal antibody, is emerging in CV: nevertheless, questions upon the safety of this therapeutic approach, especially in HCV patients, are still being issued and universally accepted recommendations that can help physicians in MCS treatment are lacking. A Consensus Committee provided a prioritized list of research questions to perform a systematic literature review (SLR). A search was made in Medline, Embase, and Cochrane library, updated to August 2021. Of 1227 article abstracts evaluated, 27 studies were included in the SLR, of which one SLR, 4 RCTs, and 22 observational studies. Seventeen recommendations for the management of mixed cryoglobulinemia with rituximab from the Italian Study Group of Cryoglobulinemia (GISC) were developed to give a valuable tool to the physician approaching RTX treatment in CV.