RESEARCH - Rituximab therapy in RA in daily practice

[Guest guest]

J Rheumatol. 2008 Jan;35(1):31-4. Epub 2007 Nov 15.

Rituximab therapy in rheumatoid arthritis in daily practice.

Assous N, Gossec L, Dieudé P, Meyer O, Dougados M, Kahan A, Allanore Y.

From the Departments of Rheumatology A and Rheumatology B, Paris Descartes

University, Medical Faculty, Cochin Hospital, AP-HP, and Department of

Rheumatology, Paris VII University, Bichat Hospital, AP-HP, Paris, France.

OBJECTIVE: Rituximab has been shown to be effective in refractory rheumatoid

arthritis (RA) in randomized controlled trials, allowing approval by health

agencies. Our aim was to assess in routine care the effects of rituximab in

patients with RA who had experienced an inadequate response to anti-tumor

necrosis factor-alpha (TNF-alpha) agents or had a contraindication to these

drugs. METHODS: An observational retrospective study was conducted.

Rituximab (1000 mg intravenous infusion on Days 1 and 15) was administered

with concomitant methotrexate therapy. Responses defined according to the

European League Against Rheumatism (EULAR criteria) were assessed at Week

24. RESULTS: Fifty patients were included: 30 had inadequate response to

anti-TNF-alpha and 20 had contraindication to anti-TNF-a drugs. EULAR

response was observed in 82%, good response in 36% (including remission in

12%), moderate response in 46%, and no response in 18%. One infusion-related

reaction and 2 pulmonary infections occurred. Eleven of the 50 patients

(22%) experienced flare and received retreatment with rituximab at 6 months.

Thirty additional patients had flare after 6 months and the median delay for

retreatment among the 41 responders was 9 (range 6 24) months. No difference

regarding efficacy or tolerance of rituximab was observed according to

previous inadequate response or contraindication to anti-TNF.

CONCLUSION: A single cycle of rituximab, in combination with continued

methotrexate, provided significant improvement in disease activity at Week

24, with good tolerance, in patients with severe and active RA despite

anti-TNF-alpha agents and/or with contraindication to these drugs, in this

daily practice study.

PMID: 18176989

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve & db=PubMed & list_uids=18

176989

Not an MD