Rituximab therapy in rheumatoid arthritis in daily practice

• Published in: Journal of rheumatology Vol. 35; no. 1; pp. 31 - 34
• Main Authors: ASSOUS, Noémie, GOSSEC, Laure, DIEUDE, Phillippe, MEYER, Olivier, DOUGADOS, Maxime, KAHAN, Andre, ALLANORE, Yannick
• Format: Journal Article
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-01-2008; Journal of Rheumatology Publishing
• Subjects: Aged; Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal, Murine-Derived; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Biological and medical sciences; Diseases of the osteoarticular system; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Immunologic Factors - administration & dosage; Immunomodulators; Inflammatory joint diseases; Male; Medical sciences; Methotrexate - therapeutic use; Middle Aged; Pharmacology. Drug treatments; Retrospective Studies; Rituximab; Treatment Outcome; Antineoplastic agent; Immunopathology; Diseases of the osteoarticular system; Rituximab; Autoimmune disease; Inflammatory joint disease; Monoclonal antibody; Immunomodulator; Chronic; Treatment; Rheumatoid arthritis; OPEN-LABEL TRIAL; Immunosuppressive agent
• ISSN: 0315-162X; 1499-2752

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.