Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration

被引：17

作者：

Chatzidionysiou, Katerina ^{[1
]}

Lie, Elisabeth ^{[2
]}

Lukina, Galina ^{[3
]}

Hetland, Merete L. ^{[4
,5
]}

Hauge, Ellen-Margrethe ^{[6
]}

Pavelka, Karel ^{[7
]}

Gabay, Cem ^{[8
]}

Scherer, Almut ^{[9
]}

Nordstrom, Dan ^{[15
]}

Canhao, Helena ^{[10
]}

Santos, Maria Jose ^{[10
]}

Tomsic, Matija ^{[11
]}

Rotar, Ziga ^{[11
]}

Victoria Hernandez, M. ^{[12
]}

Gomez-Reino, Juan ^{[13
]}

Ancuta, Ioan ^{[14
]}

Kvien, Tore K. ^{[2
]}

van Vollenhoven, Ronald ^{[1
]}

机构：

[1] Karolinska Inst, Dept Med, Unit Clin Therapy Res Inflammatory Dis ClinTRID, Stockholm, Sweden

[2] Diakonhjemmet Hosp, Dept Rheumatol, Oslo, Norway

[3] Inst Rheumatol, ARBITER, Moscow, Russia

[4] Rigshosp, Ctr Head & Orthopaed, Ctr Rheumatol & Spine Dis, DANBIO, Glostrup, Denmark

[5] Univ Copenhagen, Dept Clin Med, Fac Hlth & Med Sci, Copenhagen, Denmark

[6] Aarhus Univ Hosp, Dept Rheumatol, Aarhus, Denmark

[7] Inst Rheumatol, Prague, Czech Republic

[8] Univ Hosp Geneva, Swiss Clin Qual Management SCQM Registry, Geneva, Switzerland

[9] SCQM Fdn, Zurich, Switzerland

[10] Univ Lisbon, Fac Med, Inst Med Mol, Reuma Pt Registry, Lisbon, Portugal

[11] BioRx Si Univ, Med Ctr, Ljubljana, Slovenia

[12] Hosp Clin Barcelona, Dept Rheumatol, Barcelona, Spain

[13] Hosp Clin Univ Santiago, Santiago, Spain

[14] Cantacuzino Hosp, Bucharest, Romania

[15] Univ Helsinki, Cent Hosp, Helsinki, Finland

来源：

JOURNAL OF RHEUMATOLOGY | 2017年 / 44卷 / 02期

关键词：

RHEUMATOID ARTHRITIS; RITUXIMAB; RETREATMENT; DOSE RITUXIMAB; DOUBLE-BLIND; EFFICACY; THERAPY; SAFETY; METHOTREXATE; REGIMENS;

D O I：

10.3899/jrheum.160460

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Objective. Several aspects of rituximab (RTX) retreatment in rheumatoid arthritis (RA) need to be further elucidated. The aim of this study was to describe the effect of repeated courses of RTX on disease activity and to compare 2 retreatment strategies, fixed-interval versus on-flare retreatment, in a large international, observational, collaborative study. Methods. In the first analysis, patients with RA who received at least 4 cycles with RTX were included. In the second analysis, patients who received at least 1 RTX retreatment and for whom information about the strategy for retreatment was available were identified. Two retreatment strategies (fixed-interval vs on-flare) were compared by fitting-adjusted, mixed-effects models of 28-joint Disease Activity Score (DAS28) over time for first and second retreatment. Results. A total of 1530 patients met the eligibility criteria for the first analysis. Significant reductions of mean DAS28 between the starts of subsequent treatment cycles were observed (at start of first treatment cycle: 5.5; second: 4.3; third: 3.8; and fourth: 3.5), suggesting improved response after each additional cycle (p < 0.0001 for all pairwise comparisons). A total of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6-4.1 vs 4.6, 95% CI 4.5-4.7, p < 0.0001). Similar results were found for the second retreatment. Conclusion. Repeated treatment with RTX leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment.

引用

页码：162 / 169

页数：8

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