Ann Rheum Dis 70:877-878 doi:10.1136/ard.2010.136093
  • Letters

Statins inhibit the antirheumatic effects of rituximab in rheumatoid arthritis: results from the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry

  1. J Fransen1
  1. 1Department of Rheumatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  2. 2Department of Rheumatology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
  3. 3Department of Rheumatology, Maartenskliniek, The Netherlands
  4. 4Department of Rheumatology, Medisch Spectrum Twente and University of Twente, Enschede, The Netherlands
  5. 5Department of Rheumatology, Gelderse Vallei Hospital, Ede, The Netherlands
  1. Correspondence to E E A Arts, Radboud University Nijmegen Medical Centre, Department of Rheumatology, Geert Grooteplein 8, Huispost 470, 6500 HB Nijmegen, The Netherlands; e.arts{at}
  1. Contributors EEAA had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Accepted 20 August 2010
  • Published Online First 18 October 2010

Rituximab (RTX) is used for the treatment of lymphomas and rheumatoid arthritis (RA), achieving its beneficial effect through B cell depletion.1 2 Recently it has been suggested that the effect of RTX may be inhibited by the concomitant use of statins.3,,5 B cell depletion is achieved through apoptosis of B cells induced by hypercrosslinking of CD20 molecules with RTX. This process depends on the presence and integrity of lipid rafts in the cell membrane.3 6 7 In vitro, Winiarska et al showed that cholesterol depletion reduces apoptosis by RTX, inhibiting B cell depletion.3 However, two clinical studies that investigated concomitant statin use in patients with lymphoma reported no diminished effect on patient survival.8 9 These patients …