Researchers find new way to attack inflammation in Graves' e...( Ann Arbor Mich. A small group of pa...),Health

Ann Arbor, Mich. A small group of patients with severe Graves' eye disease experienced rapid improvement of their symptoms and improved vision following treatment with the drug rituximab. Inflammation around their eyes and damage to the optic nerve were significantly reduced. The same patients had not previously responded to steroids, a common treatment for Graves' eye disease.

Raymond S. Douglas, M.D., Ph.D., an oculoplastics specialist who recently joined the faculty of the U-M Kellogg Eye Center, reports on the potential of the drug in the online October issue of Ophthalmology. Douglas reviewed the progress of six patients he treated while on the faculty of the University of California at Los Angeles.

Graves' eye disease is an autoimmune disease that causes inflammation and fatty deposits in the eye muscles and connective tissue surrounding the eye. Among the symptoms are pronounced bulging eyes, retracted eyelids, dry eyes, and, in severe cases, loss of vision. Women are more likely than men to develop the disease.

The study suggests that rituximab is a potentially effective new treatment for the most severe forms of Graves' eye disease. "These patients had already received the maximum level of steroid treatment," says Douglas. "Treatment with rituximab calmed inflammation, stopped progression of the disease, and saved the patients from having to undergo surgery."

Rituximab has been used to treat patients with other autoimmune diseases, including rheumatoid arthritis and in non-Hodgkin's B-cell lymphoma. The drug works by depleting B cellsthe body's normal antibody-producing cellsthat appear to go awry in autoimmune diseases.

Collaborating with Terry J. Smith, M.D., the Frederick G.L. Huetwell Professor of Ophthalmology and Visual Sciences, Douglas has helped to explain the process by which the immune system attacks the orbital tissue in Graves' eye disease. In an earlier study, the researchers report
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