Objectives To evaluate the dynamics of effective therapy with Rituximab according to Eular criteria (DAS28) among patients with rheumatoid arthritis (RA) by the results of prospective four-year follow-up.
Methods We observed 56 patients were under observations having definite diagnosis of RA treated with combined therapy of Methotrexate (mean dose of 13.22±0.28 mg/week) and Rituximab by a standard scheme (1000 mg intravenously in the 1st and 15th days, the course - 2 infusions, the average number of courses - 3.65±0.09). Average value of DAS28 - 5.07 [4.18; 6.14]. Determination of disease activity by DAS28 was conducted in different periods of observation: after 16,24 weeks of therapy, in 12, 24, 36 and 48 months. To evaluate the treatment efficacy, criteria EULAR (DAS28) was used. All patients were distributed in different periods of observations into two groups depending on the indicator ΔDAS28: “responders” - ΔDAS28 ≥1.2; “nonresponders” - ΔDAS28 <1.2.
Results The ratio of the proportion of “responders” and “nonresponder” in different periods of follow-up was respectively: 16 weeks - 46.4% and 53.6% (p=0.44), 24 weeks - 57.1% and 42.9% (p=0.14), 12 months - 67.9% and 32.1% (p=0.001) and 24 months - 64.3% and 35.7% (p=0.02) months 36 - 64, 3% and 35.7% (p=0.02), 48 months - 51.8% and 48.2% (p=0.07). The percentage of “responders” baseline (46.4%) and in the follow-up period was 24 weeks - 57.1% (p=0.26), 12 months - 67.9% (p=0.02), 24 months - 64.3% (p=0.05) and 36 months - 64.3% (p=0.05) and 48 months - 51.8% (p=0.5).
Conclusions Effectiveness of Rituximab gradually increased to the 12th months of treatment, remained stable in the range of 24-36 months of treatment and decreased to 48 months of observation.
Disclosure of Interest None declared
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