Background With the advent of biological therapy a range of new drugs have come available for patients with rheumatoid arthritis (RA). Rituximab (RTX) is a lesser known, but effective treatment option for patients with RA. Obviously, data on long-term efficacy and safety in daily clinical practice is important as results obtained in short-term clinical registration trials might differ from those observed in long-term daily clinical practice.
Objectives To ascertain the efficacy of long- term RTX treatment for RA
Methods From February 2009 to February 2014, 97 consecutive patients were included in the rituximab for RA cohort at the Jan van Breemen research centre in Amsterdam, the Netherlands.
Results The mean age was 58 years (SD:13), and 74 (76%) were female. At baseline, the median disease duration was 12 (5-18) years, and 75 (79%) were Rheumatoid factor positive. At baseline, 38 (41%) used methotrexate, 46 (49%) used prednisolone, and 18 (19%) a DMARD other than MTX. On average patients had used 3.4 (SD:1.6) DMARDs, 1.5 (1.1) biologicals. At 72, most (77%) patients had used at least one biological prior to start of rituximab. A total of 66 (68%) patients are currently on drug, and 31 (32%) patients have dropped out. The median follow-up duration was 1.1 (IQR:0.6-1.9) years for patients currently still on rituximab treatment, and 0.6 (0.1-1.1) years for drop-outs. The maximum follow-up duration was 3.8 years.
The mean DAS-28 dropped significantly from 5.2 (SD: 1.4) at baseline to 4.3 (1.4) at 12 weeks. This improvement was sustained, and steadily improved further over the whole 3 years (see figure). The patient reported outcome of the health assessment questionnaire (HAQ) also showed a good initial response, however rose to baseline levels after 1.5 years before dropping again and much lower (see figure).
Conclusions The initial good response on rituximab persists for at least 3 years of follow-up, with the decrease in DAS28 continuing for the entire 3 years. Over time, a satisfactory response both in HAQ and DAS28 was sustained.
Disclosure of Interest None declared