Background Rituximab is one of the treatment options in rheumatoid arthritis (RA) patients and officially recommended as a maintanance treatment given every 6 months after the initial loading of first course.
Objectives In this real life study, it was aimed to investigate the infusion frequency of rituximab maintanance treatment and possible effects on disease activity.
Methods The HUR-BIO is a single-center biologic registry of Hacettepe University which is established in Ankara and in which patients have been prospectively recorded since 2012. This database has 1235 RA patient records as of August 2016. Rituximab was prescribed at least once in 273 (22.1%) patients. The residence address of 85 those patients was within the boundaries of center city (Ankara) and they were included in to the study. In our clinic, the dates and the DAS-28 scores at the time of rituximab courses were recorded. Rituximab infusion compliance was classified as; “regular ” if there is less than one month delay, “slightly irregular” if less than 3 months delay and “irregular” if more than 3 months delay.
Results The mean age of the 85 patients (80% female) was 59.1 (10.1), the mean disease duration was 12.9 (8.6) years and 74.1% of patients were seropositive. 39/85 (46%) patients previously used at least one biological agent (46 (54%) patients were biologic naive before Rituximab therapy). Median rituximab course number was 3 (1–8). A total of 211 rituximab courses were given to 85 patients. Rituximab course number and percentage is shown in figure. The mean interval time between rituximab courses was 7.9 (2.8) months. Total of 102 (52.6%) courses were admistred at normal times regularly, 60 (30.9%) were slightly irregular and 32 (16.5%) were irregular. There was no significant difference between the mean DAS-28 responses in the time of the courses and the rituximab infusion compliances [in regular group mean DAS-28 was 3.31 (1,19), in slightly irregular group mean DAS-28 was 3.26 (1.35) and irregular group mean DAS-28 was 3,57 (1.34), p>0.05]. Before rituximab courses, 33.7% of patients had remission, 19.1% had low disease activity, 36.3% had moderate disease activity and 10.9% had high disease activity.
Conclusions Rituximab administration was approximately 2 months delayed in RA patients who were living in center-city boundaries. The pre-treatment mean disease activity scores were similar, even if there was a delay in rituximab administration. In our center, about 85% of patients were taking RTX courses regular and/or slightly irregular and about half of the patients before treatment were in remission and/or low disease activity.
Disclosure of Interest None declared