Background Rituximab (RTX) is a biotherapy usually recommended during the rheumatoid arthritis (RA) refractory to at least one anti-TNFα. In our country RTX surpassed the anti TNF α in the treatment (TRT) of RA and received its AMM in refractory RA and/or in case of intolerance to conventional TRT. The objective of this study was to evaluate the tolerance and efficiency of RTX in patients suffering of RA and naive of anti-TNF α.
Objectives The objective of this study was to evaluate the tolerance and efficiency of RTX in patients suffering of RA and naive of anti-TNF α.
Methods it’s an observational and retrospective study, including 59 patients suffering from RA, treated with rituximab after failure of conventional TRT between October 2007 and September 2011. The data collected were: the patient characteristics, the disease characteristics, the type of TRT, the dose of corticosteroids, the rate of leukocytes, of Ig A, G, M, the immediate and delayed side effects. The therapeutic response was retained on the EULAR criteria, combined with the evaluation of the physician.
Results 59 patients (46 women and 13 men) were treated with RTX (1000 mg x2), with retreatment in 13 cases. The average age was 47.5 years, the average duration of illness was 11.5 years, the Rheumatoid Factor was positive in 80%, the anti-CCP positive in 78%, the average number of previous disease modifying TRT was 2.52. methotrexate in 38 cases, leflunomide in 6 cases, 3 cases at salazopyrine, used in monotherapy in 12 cases. The initial DAS28 was in average 5.06 (3.1-7.02), the initial average rate of gammaglobulines was 12.2g/l on the 59 patients, 81% had a favorable response to treatment with an average decrease in individual DAS 28 of - 2.3. All were considered to have responded favorably to treatment. 13 patients (22%) relapsed and required retreatment.
(8: 2 courses: 5: 3 courses, the time between two courses was between 8 and 28 months), followed by a good response. The Side effects observed during the perfusion: 5 cases headache, 4 cases arterial hypotension, 1 case of generalized pruritus, asthenia reported by all patients within 24 to 48 h after the perfusion. Other side effects were: 6 cases of infections (01 severe purulent conjunctivitis, 01skin infection, 03 urinary, 1pulmonary). No deaths, no case of tuberculosis, no decrease in immunoglobulin, no leukopenia in retreated patients.
Conclusions This particular study using RTX during the RA naive of anti-TNF alpha, shows a remarkable efficiency of RTX, the tolerance of RTX is in total satisfactory even after retreatment.
Disclosure of Interest None Declared
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