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Treatment

Authoring team

The approach depends upon the severity of the disease. Plasmapheresis may reduce the levels of cryoglobulin. Any underlying condition should be treated where possible including hepatitis C (1).

Rituximab (a monoclonal antibody targeted to CD20 on B cells) may be considered in selected patients (who do not have evidence of active HIV or hepatitis B infection) with: (2)

  • moderate to severe or severe-rapidly progressive MC
  • cryoglobulinaemic vasculitis
  • comorbidities that preclude other therapies

References

  1. Sise ME, Bloom AK, Wisocky J, et al. Treatment of hepatitis C virus-associated mixed cryoglobulinemia with direct-acting antiviral agents. Hepatology. 2016 Feb;63(2):408-17.
  2. Quartuccio L, Bortoluzzi A, Scirè CA, et al. Management of mixed cryoglobulinemia with rituximab: evidence and consensus-based recommendations from the Italian Study Group of Cryoglobulinemia (GISC). Clin Rheumatol. 2023 Feb;42(2):359-70.

 

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