Background Retreatment with rituximab (RTX) is common clinical practice, although several aspects regarding retreatment, such as frequency, need to be further elucidated.
Objectives The aim of this study was to describe the effectiveness of repeated courses of RTX in a large observational cohort of real-life patients with RA.
Methods Pooled data from the Collaborating European Registries for Rituximab in RA (CERERRA) project were used. Patients with RA who received at least 4 cycles with RTX were identified and included in the analysis. A covariate-adjusted mixed effects model was fitted to the longitudinal DAS28 for patients with complete covariate information, including country, sex, age, anti-CCP status, number of prior biologics and concomitant DMARD treatment.
Results 340 patients met the eligibility criteria for these analyses. At baseline (start of RTX) the mean (SD) age was 53.5 (12.6) years, mean (SD) disease duration 12.1 (8.2) years, 83% were females, 79% RF positive and 74% anti-CCP positive. 60% were treated with corticosteroids and 84% with concomitant DMARD. Patients had failed 2.7 (1.5) prior synthetic DMARDs and 1.1 (1.0) prior biologic DMARDs. The baseline DAS28 was 6.0 (1.4). The mean fixed predicted decrease of DAS28 after the first cycle and after each retreatment (1st, 2nd and 3rd) is shown in figure 1. Significant improvement in DAS28 (p<0.001) was observed for each course of RTX. Comparison between curves (based on estimated marginal means) revealed significant difference between all curves except between 3rd and 4th treatment cycle, suggesting that a more stable DAS28 is achieved after 2nd retreatment.
Conclusions Repeated retreatment with RTX can lead to further clinical improvement after the first course of RTX. A trend for stabilization of disease activity score was observed after the 2nd retreatment.
Disclosure of Interest K. Chatzidionysiou: None declared, E. Lie Consultant for: AbbVie, BMS, Hospira, Pfizer, UCB, Speakers bureau: AbbVie, BMS, Pfizer, Roche, UCB, E. Nasonov Grant/research support: Roche, G. Lukina Grant/research support: Roche, M. Hetland Speakers bureau: AbbVie, BMS, MSD, Pfizer, U. Tarp: None declared, K. Pavelka: None declared, C. Gabay Consultant for: Roche, D. Nordström Grant/research support: Roche, H. Canhão: None declared, M. Tomsic: None declared, P. van Riel: None declared, J. Gomez-Reino: None declared, I. Ancuta: None declared, T. Kvien Grant/research support: to the Diakonhjemmet Hospital from AbbVie, BMS, MSD/Schering-Plough, Pfizer/Wyeth, Roche and UCB, Consultant for: AbbVie, BMS, Celltrion, Eli Lilly, Hospira, MSD/Schering-Plough, Orion Pharma, Pfizer/Wyeth, Roche, UCB, Speakers bureau: AbbVie, BMS, Celltrion, Eli Lilly, Hospira, MSD/Schering-Plough, Orion Pharma, Pfizer/Wyeth, Roche, UCB, R. van Vollenhoven Grant/research support: AbbVie, BMS, GSK, Pfizer, Roche, UCB, Consultant for: AbbVie, Biotest, BMS, Crescendo, GSK, Janssen, Lilly, Merck, Pfizer, Roche, UCB, Vertex