{Reference Type}: Systematic Review
{Title}: Management of mixed cryoglobulinemia with rituximab: evidence and consensus-based recommendations from the Italian Study Group of Cryoglobulinemia (GISC).
{Author}: Quartuccio L;Bortoluzzi A;Scirè CA;Marangoni A;Del Frate G;Treppo E;Castelnovo L;Saccardo F;Zani R;Candela M;Fraticelli P;Mazzaro C;Renoldi P;Scaini P;Filippini DA;Visentini M;Scarpato S;Giuggioli D;Mascia MT;Sebastiani M;Zignego AL;Lauletta G;Fiorilli M;Casato M;Ferri C;Pietrogrande M;Pioltelli PE;De Vita S;Monti G;Galli M;
{Journal}: Clin Rheumatol
{Volume}: 42
{Issue}: 2
{Year}: Feb 2023
{Factor}: 3.65
{DOI}: 10.1007/s10067-022-06391-w
{Abstract}: 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.