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Statins inhibit the antirheumatic effects of rituximab in rheumatoid arthritis: results from the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry
  1. E E A Arts1,
  2. T L Jansen2,
  3. A Den Broeder3,
  4. H E Vonkeman4,
  5. E Dutmer5,
  6. M A F J Van de Laar4,
  7. P L C M Van Riel1,
  8. J Fransen1
  1. 1Department of Rheumatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
  2. 2Department of Rheumatology, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
  3. 3Department of Rheumatology, Maartenskliniek, The Netherlands
  4. 4Department of Rheumatology, Medisch Spectrum Twente and University of Twente, Enschede, The Netherlands
  5. 5Department of Rheumatology, Gelderse Vallei Hospital, Ede, The Netherlands
  1. Correspondence to E E A Arts, Radboud University Nijmegen Medical Centre, Department of Rheumatology, Geert Grooteplein 8, Huispost 470, 6500 HB Nijmegen, The Netherlands; e.arts{at}

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Rituximab (RTX) is used for the treatment of lymphomas and rheumatoid arthritis (RA), achieving its beneficial effect through B cell depletion.1 2 Recently it has been suggested that the effect of RTX may be inhibited by the concomitant use of statins.3,,5 B cell depletion is achieved through apoptosis of B cells induced by hypercrosslinking of CD20 molecules with RTX. This process depends on the presence and integrity of lipid rafts in the cell membrane.3 6 7 In vitro, Winiarska et al showed that cholesterol depletion reduces apoptosis by RTX, inhibiting B cell depletion.3 However, two clinical studies that investigated concomitant statin use in patients with lymphoma reported no diminished effect on patient survival.8 9 These patients …

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  • Funding Funding of the Dutch affiliations of Wyeth Pharmaceuticals, Abbott Pharmaceuticals, Schering-Plough Corporation, Roche Pharmaceuticals, UCB Pharma and Bristol-Myers Squibb enabled the data collection for the DREAM cohort.

  • Competing interests The DREAM registry is funded by several pharmaceutical industries including Roche Pharmaceuticals.

  • Ethics approval The protocol of the DREAM registry has been approved by the responsible medical ethical committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.