Background and Objective The prediction of therapeutic response to Rituximab in Rheumatoid Arthritis is still an unmet need. This study aimed to identify useful and accessible predictive factors of non-responders to Rituximab ahead of time.
Materials and Methods 42 RA patients initiating Rituximab were included in this study and were prospectively followed for 18 months. The lymphocyte count (LyC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-CCP antibodies (ACPA) titres, disease duration and number of previous anti-TNFα drugs were assessed at baseline, at 6 and 18 months. The clinical response was evaluated using disease activity score (DAS28) based on ESR and European League Against Rheumatism (EULAR) response at 6 (ER6) and 18 months (ER18).
Results LyC at baseline is predictive for ER6 (F=4.597, p=0.041), but not for ER18, and the ER6 is predictive for ER18 (F=8.834, p=0.005). Also DAS28 at 6 months and the number of previous anti-TNFα drugs are predictive for ER18 (F=7.937, p=0.008, respectively F=4.356, p=0.044). Although we obtained a negative correlation between the ESR at 6 months and ER18 (p=0.002), the therapeutic response cannot be predicted based on ESR values. RF and ACPA titres, CRP values and the disease duration did not seem to correlate with the therapeutic response.
Conclusions: The lymphocyte count at baseline represents a predictive factor for the EULAR response at 6 months. A better 6 months ER along with a lower DAS28 predict a better ER at 18 months of Rituximab treatment in RA patients.
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