Rituximab fixed retreatment versus on-demand retreatment in refractory rheumatoid arthritis: comparison of two B cell depleting treatment strategies

Y K O Teng¹, J Tekstra², F C Breedveld¹, F Lafeber², J W J Bijlsma², Jacob M van Laar^1,3

¹ Department of Rheumatology, Leiden University Medical Center, The Netherlands
² Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, The Netherlands
³ Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, UK

Correspondence to:
J M van Laar, Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK; j.m.van-laar@ncl.ac.uk

Accepted 4 September 2008

The first 150 words of the full text of this article appear below.

Rituximab, an anti-CD20 monoclonal antibody, has been approved for treatment in patients with rheumatoid arthritis (RA) who have failed treatment with tumour necrosis factor (TNF) blocking agents.¹ Previous studies have demonstrated its safety, efficacy and prevention of radiographic progression;^{2 3} however few studies have yet addressed the timing of repeated courses of rituximab. A study in 22 patients with RA showed that treatment with repeated courses of rituximab over a 5-year follow-up period was safe and well tolerated⁴ and additionally an open-label extension study of 3 large randomised, double-blind studies in patients with RA showed that clinical efficacy was maintained with subsequent courses of rituximab, comparable to the first rituximab course, without increased additional safety concerns.⁵ Interestingly, one study reported that rituximab retreatment was more effective; however, this was in patients whose disease activity had not completely returned to baseline levels.⁶ Therefore, the preferred timing of repeated treatment courses of rituximab . . . [Full text of this article]

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