ORIGINAL PAPER
Effectiveness and safety of the use of rituximab in patients with active rheumatoid rthritis – 5 years’ personal observations
Online publication date: 2013-03-05
Reumatologia 2013;51(1):20-25
KEYWORDS
ABSTRACT
The aim of this study was to assess the effectiveness and safety of rituximab (RTX) treatment in patients with severe, active rheumatoid arthritis (RA) in the years 2007–2012.
Material and methods: The study was conducted on 38 adult patients with active RA (DAS28 > 3.2) who were enrolled in the RTX treatment program as a second or third line drug. The primary or secondary ineffectiveness of anti-TNF therapy was observed in those patients. The group consisted of 31 women (81.6%) and 7 men (18.4%). The average age was 54.6 ±11.25 years, and the average duration of RA was 16.3 ±7.9 years. The RTX effectiveness was assessed during 36 months using EULAR criteria.
Results: At the 6th, 12th, 24th, 30th and 36th month of observation a good response to RTX treatment was demonstrated by 18.4%, 30.0%, 21.7%, 64.3% and 88.9% of patients, respectively. At the same time a moderate response was found in 73.7%, 53.3%, 60.9%, 14.3% and 0.0% and no response in 7.9%, 16.7%, 17.4%, 21.4% and 11.1% of patients, respectively. There were 2 non-responders (5.3%) to the initial treatment with RTX. We observed secondary ineffectiveness of RTX therapy in 10 patients (26.3%).
During the course of RTX treatment the number of patients receiving oral corticosteroids was reduced from 34 (89.5%) to 16 (42.1%) (p < 0.001). In the remaining patients the mean dose of corticosteroids was lowered by 23.8%. The following adverse effects during RTX infusion were recorded in 3 (7.9%) patients: Quincke’s edema, hypotonia and itching of the skin. Infections were observed in 5 (13.1%) of the treated patients.
Conclusions: RTX treatment is a safe and effective form of therapy in patients with active, long-term RA previously treated with various DMARDs.
Material and methods: The study was conducted on 38 adult patients with active RA (DAS28 > 3.2) who were enrolled in the RTX treatment program as a second or third line drug. The primary or secondary ineffectiveness of anti-TNF therapy was observed in those patients. The group consisted of 31 women (81.6%) and 7 men (18.4%). The average age was 54.6 ±11.25 years, and the average duration of RA was 16.3 ±7.9 years. The RTX effectiveness was assessed during 36 months using EULAR criteria.
Results: At the 6th, 12th, 24th, 30th and 36th month of observation a good response to RTX treatment was demonstrated by 18.4%, 30.0%, 21.7%, 64.3% and 88.9% of patients, respectively. At the same time a moderate response was found in 73.7%, 53.3%, 60.9%, 14.3% and 0.0% and no response in 7.9%, 16.7%, 17.4%, 21.4% and 11.1% of patients, respectively. There were 2 non-responders (5.3%) to the initial treatment with RTX. We observed secondary ineffectiveness of RTX therapy in 10 patients (26.3%).
During the course of RTX treatment the number of patients receiving oral corticosteroids was reduced from 34 (89.5%) to 16 (42.1%) (p < 0.001). In the remaining patients the mean dose of corticosteroids was lowered by 23.8%. The following adverse effects during RTX infusion were recorded in 3 (7.9%) patients: Quincke’s edema, hypotonia and itching of the skin. Infections were observed in 5 (13.1%) of the treated patients.
Conclusions: RTX treatment is a safe and effective form of therapy in patients with active, long-term RA previously treated with various DMARDs.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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