RESEARCH - Rituxan (rituximab) use in everyday clinical practice as a first-line biologic therapy for RA

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Rheumatology (Oxford). 2008 Apr 4

Rituximab use in everyday clinical practice as a first-line biologic

therapy for the treatment of DMARD-resistant rheumatoid arthritis.

McGonagle D, Tan AL, Madden J, L, Emery P.

Department of Rheumatology, Calderdale Royal Hospital, Salterhebble,

Halifax and Academic Unit of Musculoskeletal Disease, University of

Leeds and Chapel Allerton Hospital, Leeds, UK.

Objectives. This study assessed the utility of rituximab for the

therapy of RA in a non-academic environment in a group of cases where

anti-TNF was either not available or relatively contraindicated.

Methods. Thirty-nine patients with active RA who had failed at least

one DMARD received two rituximab infusions 2 weeks apart. Seventeen

patients received two 1000 mg doses, and 22 received the 500 mg

regimen. The 28-joint disease activity index (DAS28) and European

League against Rheumatism (EULAR) response criteria were recorded at

baseline, 3, 6, 9 and 12 months. RF and ANA were recorded at baseline

and at 6 and 12 months. Results. There was a significant improvement

in the DAS28 at all time points, and EULAR response was observed in 29

of 33 patients (87.9%) at 3 months, 25 of 33 patients (75.8%) at 6

months, 22 of 29 patients (75.9%) at 9 months and 23 of 30 patients

(76.7) at 12 months. Improvement was also noted in CRP, and both RF

and ANA were generally reduced after treatment. Patients who were on

the higher regimen of two 1000 mg doses appeared to respond slightly

better compared with the lower dose regimen.

Conclusions. Rituximab is well tolerated in everyday clinical practice

and may represent a good short-term treatment option where anti-TNF

therapy is either unavailable or relatively contraindicated.

PMID: 18390581

http://www.ncbi.nlm.nih.gov/pubmed/18390581

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