Avtor/Urednik     Chatzidionysiou, Katerina; Lie, Elisabeth; Lukina, Galina; Hetland, Merete L.; Hauge, Ellen Margrethe; Pavelka, Karel; Gabay, Cem; Scherer, Almut; Tomšič, Matija; Rotar, Žiga
Naslov     Rituximab retreatment in rheumatoid arthritis in a real-life cohort
Tip     članek
Vol. in št.     Letnik 44, št. 2
Leto izdaje     2017
Obseg     str. 162-169
ISSN     0315-162X - The Journal of rheumatology
Jezik     eng
Abstrakt     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.
Proste vsebinske oznake     rheumatoid arthritis
Rituximab
retreatment
revmatoidni artritis
Rituximab
apliciranje