Is relapse common after treatment with RTX in HCV associated Mixed cryoglobulinemia?
Treatment effect is usually durable and has been demonstrated for >2 years after a single treatment course. Relapse occurs in ∼20% of cases and seems to be less frequent with combination therapy versus either RTX or AV monotherapy. Immunologic relapse and B-cell recovery commonly precede clinical relapse in many patients. Most patients with a clinical relapse also have viral recurrence or an initial lack of viral response. However, not all patients with an immunologic relapse (decreased C4, increased cryoglobulins, return of B cells) experience a clinical relapse; therefore the use of lab measurements to predict relapse is limited. RTX has been proven effective in the setting of clinical relapse and should be, thus, considered in this setting.
