To provide a comprehensive review of rituximab use for the treatment of non-infectious/non-malignant orbital inflammation. Review of literature through January 2021. Individual data was available for 167 patients with refractory non-infectious/non-malignant orbital inflammation who received treatment with rituximab (RTX). Rituximab was generally utilized as third-line or later treatment (108/149, 72.5%) at a mean of 44.6 months following the diagnosis of orbital inflammation (range = 0 to 360 months; median = 13.7 months). Patients with non-infectious/non-malignant orbital inflammation either received prior treatment with corticosteroids only (27/122, 22.1%), or with one (31/122, 25.4%), two (25/122, 20.5%), or three or more (25/122, 20.5%) corticosteroid-sparing immunosuppressive agents with or without corticosteroids before initiation of RTX treatment. The rheumatologic protocol (two infusions of 1 gram of RTX separated by 14 days) was utilized most frequently (80/144, 55.6%), followed by the oncologic protocol (four weekly infusions of 375 mg/m2 RTX; 51/144, 35.4%). Various other off-label regimens were used infrequently (13/144, 9.0%). Rituximab treatments resulted in a positive therapeutic response for the majority of patients with orbital inflammation (146/166, 88.0%). Commonly treated diagnoses included granulomatosis with polyangiitis (99/167, 59.3%), IgG-4 related disease (36/167, 21.6%), and orbital inflammation of indeterminate cause (25/167, 15.0%). No side effects were reported in 83.3% (55/66) of cases. The most common RTX-induced adverse event was an infusion-related temporary exacerbation of orbital disease (4/66, 6.1%), which occurred prior to the routine use of systemic corticosteroids as pre-conditioning. Overall, RTX appears to be both efficacious and well-tolerated as second- or third-line therapy for patients with non-infectious/non-malignant orbital inflammation.

中文翻译：

---

利妥昔单抗用于治疗非感染性和非恶性眼眶炎症性疾病

全面综述利妥昔单抗用于治疗非感染性/非恶性眼眶炎症的情况。文献综述截至 2021 年 1 月。可获得 167 名接受利妥昔单抗 (RTX) 治疗的难治性非感染性/非恶性眼眶炎症患者的个人数据。利妥昔单抗通常在眼眶炎症诊断后平均 44.6 个月（范围 = 0 至 360 个月；中位 = 13.7 个月）时用作三线或更晚的治疗（108/149，72.5%）。患有非感染性/非恶性眼眶炎症的患者要么仅接受过皮质类固醇治疗（27/122，22.1％），要么接受过一种皮质类固醇（31/122，25.4％）、两种（25/122，20.5％）或两种皮质类固醇治疗在开始 RTX 治疗之前，使用三种或更多（25/122，20.5%）皮质类固醇保留免疫抑制剂，联合或不联合皮质类固醇。风湿病方案（两次输注 1 克 RTX，间隔 14 天）使用最频繁（80/144，55.6%），其次是肿瘤方案（每周四次输注 375 mg/m2 RTX；51/144，35.4） %）。各种其他标签外治疗方案很少使用（13/144，9.0%）。利妥昔单抗治疗对大多数眼眶炎症患者产生了积极的治疗反应（146/166，88.0%）。常见治疗诊断包括肉芽肿性多血管炎 (99/167, 59.3%)、IgG-4 相关疾病 (36/167, 21.6%) 和不明原因的眼眶炎症 (25/167, 15.0%)。83.3% (55/66) 的病例没有报告副作用。RTX 引起的最常见不良事件是输注相关的眼眶疾病暂时恶化（4/66，6.1%），该事件发生在常规使用全身皮质类固醇作为预处理之前。总体而言，RTX 作为非感染性/非恶性眼眶炎症患者的二线或三线治疗似乎既有效又具有良好的耐受性。