RT Journal Article
SR Electronic
T1 Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 374
OP 377
DO 10.1136/annrheumdis-2011-200003
VO 71
IS 3
A1 Katerina Chatzidionysiou
A1 Elisabeth Lie
A1 Evgeny Nasonov
A1 Galina Lukina
A1 Merete Lund Hetland
A1 Ulrik Tarp
A1 Piet L C M van Riel
A1 Dan C Nordström
A1 Juan Gomez-Reino
A1 Karel Pavelka
A1 Matija Tomsic
A1 Tore K Kvien
A1 Ronald F van Vollenhoven
A1 Cem Gabay
YR 2012
UL http://ard.bmj.com/content/71/3/374.abstract
AB Objectives To compare the effectiveness and safety of rituximab alone or in combination with either methotrexate or leflunomide. Methods 10 European registries submitted anonymised datasets with baseline, 3, 6, 9 and 12-month clinical data from patients who started rituximab. Results 1195 patients were treated with rituximab plus methotrexate, 177 with rituximab plus leflunomide and 505 with rituximab alone. Significantly more patients achieved a European League Against Rheumatism good response at 6 months when treated with rituximab plus leflunomide (29.1%) compared with rituximab plus methotrexate (21.1%) and rituximab alone (19.3%; p=0.02 and p=0.01, respectively). Similar results were observed at 12 months. Adverse events occurred in 10.2%, 13.2% and 13.9% of patients on rituximab plus leflunomide, rituximab plus methotrexate and rituximab alone, respectively. Conclusions Leflunomide is an effective and safe alternative to methotrexate as concomitant treatment with rituximab. Slightly better results were obtained by the combination of rituximab and leflunomide than rituximab and methotrexate, raising the possibility of a synergistic effect of leflunomide and rituximab.