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The approved dose of rituximab (RTX) in rheumatoid arthritis is 1000 mg × 2, but some data have suggested similar clinical efficacy with 500 mg × 2.
This research
showed that the dose variance of rituximab showed almost the similar outcomes
for rheumatoid arthritis (RA). Also, RTX- rituximab has been found to provide a
significant clinical improvement at 3 and 6 months in patients with active RA.
The approved dose
of rituximab (RTX) in rheumatoid arthritis is 1000 mg × 2, but some data have
suggested similar clinical efficacy with 500 mg × 2. The purpose of this study
was to compare the effectiveness of the regular and low doses given as first
treatment course.
Twelve European
registries participating in the CERERRA collaboration (The European
Collaborative Registries for the Evaluation of Rituximab in Rheumatoid
Arthritis) submitted anonymized datasets with demographic, efficacy and
treatment data for patients who had started RTX. Treatment effectiveness was assessed
by DAS28 reductions and EULAR responses after 6 months.
Data on RTX dose
were available for 2,873 patients, of whom 2,625 (91.4 %) and 248 (8.6 %)
received 1000 mg × 2 and 500 mg × 2, respectively. Patients treated with 500 mg
× 2 were significantly older, had longer disease duration, higher number of
prior DMARDs, but lower number of prior biologics and lower baseline DAS28 than
those treated with 1000 mg × 2. Fewer patients in the low-dose group received
concomitant DMARDs but more frequently received concomitant corticosteroids.
Both doses led to significant clinical improvements at 6 months. DAS28
reductions at 6 months were comparable in the 2 dose regimens [mean DeltaDAS28
± SD -2.0 ± 1.3 (high dose) vs. -1.7 ± 1.4 (low dose), p = 0.23 adjusted for
baseline differences]. Similar percentages of patients achieved EULAR good
response in the two dose groups, 18.4 % vs. 17.3 %, respectively (p = 0.36).
In this large
observational cohort initial treatment with RTX at 500 mg × 2 and 1000 mg × 2
led to comparable clinical outcomes at 6 months.
Arthritis Research & Therapy 2016
Effectiveness of two different doses of rituximab for the treatment of rheumatoid arthritis in an international cohort: data from the CERERRA collaboration
Katerina Chatzidionysiou et al.
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