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Biological treatment of rheumatoid arthritis: towards a more cost-effective re-treatment regimen using rituximab?
  1. M J H Boumans,
  2. K Vos,
  3. D M Gerlag,
  4. P P Tak
  1. Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Professor Paul P Tak, Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; p.p.tak{at}amc.uva.nl

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Treatment with rituximab may reduce disease activity in patients with rheumatoid arthritis (RA). The current dosing schedule of rituximab 2×1000 mg has been shown to induce and maintain a clinical response in initial responders and is also protective against progression of joint destruction.1,,4 Recently, the treatment schedules of 2×1000 mg and 2×500 mg rituximab were compared side-by-side in early active RA patients.4 It was shown that only initial treatment with 2×1000 mg rituximab resulted in statistically significant protection against progression of structural damage, whereas 2×500 mg and 2×1000 mg resulted in comparable clinical efficacy. Exploratory analysis suggested that re-treatment with 2×500 mg rituximab after 6 months might be protective in terms of inhibition of structural damage. Induction therapy with 2×1000 mg rituximab followed by re-treatment with 2×500 mg or 1×1000 mg after …

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