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About 30% of patients with rheumatoid arthritis fail to achieve a marked clinical response to tumour necrosis factor (TNF)α inhibitors.1 Rituximab, a chimeric monoclonal antibody, selectively depletes human CD20-positive B cells.2 In patients with rheumatoid arthritis with incomplete response to methotrexate (MTX), response with the addition of rituximab was superior to that with MTX alone.3 We carried out an observational study to assess the efficacy and safety of selective B cell depletion in the management of patients with rheumatoid arthritis refractory to TNFα inhibitors.
Ten patients fulfilling the 1987 American College of Rheumatology diagnostic criteria for rheumatoid arthritis4 and refractory to at least one anti-TNF agent for ⩾3 months were prospectively enrolled. Table 1 presents their clinical characteristics at baseline. All of them had active disease (median Disease Activity Score (DAS28) 5.28, interquartile range (IQR): 4.6–6.3).5
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