Summary of efficacy outcomes
Total population | Seropositive (RF +ve and/or ACPA +ve) subgroup | Seronegative (RF -ve and ACPA -ve) subgroup | |||||
---|---|---|---|---|---|---|---|
Placebo + MTX | Rituximab (2×500 mg) + MTX | Rituximab (2×1000 mg) + MTX | Placebo + MTX | Rituximab (2×1000 mg) + MTX | Placebo + MTX | Rituximab (2×1000 mg) + MTX | |
Joint damage outcomes (mITT population) | n=232 | n=239 | n=244† | n=211 | n=218† | n=21 | n=24† |
Week 52 | |||||||
Change in mTSS (mean) | 1.079 | 0.646 | 0.359** | 1.148 | 0.354** | 0.387 | 0.352 |
Change in erosion score (mean) | 0.738 | 0.453 | 0.233** | nc | nc | nc | nc |
% patients with no progression | 53 | 58 | 64* | 54 | 62 | 52 | 79 |
OR (unadjusted) | 1.190 | 1.517 | 1.438 | 3.455 | |||
95% CI | 0.827 to 1.712 | 1.051 to 2.189 | 0.979 to 2.114 | 0.936 to 12.743 | |||
Week 24 | |||||||
Change in mTSS (mean) | 0.701 | 0.580 | 0.328* | nc | nc | nc | nc |
% patients with no progression | 59 | 63 | 70* | nc | nc | nc | nc |
ITT | n=249 | n=249 | n=250 | n=227 | n=224 | n=22 | n=24 |
Disease activity outcomes (ITT population) week 52 | |||||||
ACR20 | 64% | 77%* | 80%*** | 64% | 81% | 64% | 71% |
ACR50 | 42% | 59%*** | 65%*** | 41% | 67% | 55% | 54% |
OR (unadjusted) | 2.043 | 2.567 | 2.915 | 0.985 | |||
95% CI | 1.430 to 2.919 | 1.788 to 3.685 | 1.986 to 4.278 | 0.308 to 3.146 | |||
ACR70 | 25% | 42%*** | 47%*** | 25% | 50% | 23% | 25% |
ACR90 | 9% | 17%* | 16%* | 8.8% | 18.3% | 13.6% | 0% |
Major clinical response | 8% | 18%* | 21%*** | nc | nc | nc | nc |
Mean ACRn | 19.5 | 42.9*** | 46.0*** | 29.8 | 58.4 | 33.6 | 40.8 |
EULAR good response | 18% | 39%*** | 42%*** | 18% | 43% | 18% | 33% |
DAS28-ESR LDA | 20% | 40%*** | 43%*** | 20% | 44% | 23% | 33% |
DAS28-ESR remission | 13% | 25%** | 31%*** | 12% | 31% | 18% | 25% |
Change in DAS28-ESR (mean)‡ | −2.06 | −3.05*** | −3.21*** | −2.60§ | −3.64§ | −2.95§ | −3.08‡ |
Physical function outcomes week 52 | |||||||
Change in HAQ-DI (mean)‡ | −0.628 | −0.905*** | −0.916*** | nc | nc | nc | nc |
% With HAQ-DI decrease ≥0.22 | 77 | 87* | 88* | nc | nc | nc | nc |
↵* p<0.05,
↵** p<0.001,
↵*** p<0.0001 for differences vs placebo+MTX.
↵† Total number of patients included in rituximab 2×1000 mg autoantibody subgroups differed by two versus total number of patients included in rituximab 2×1000 mg group throughout because two patients could not be classified (RF-negative but no ACPA data, so unable to be assigned to either group).
↵‡ Adjusted mean presented for total population; standard mean presented for subgroups (where available). Analyses included baseline scores as additional covariates.
↵§ No statistical analysis was performed on the subgroup data.
Van Elteren test for difference in distribution of changes in radiographic variables; ANOVA model adjusted for stratification factors (RF, region) (adjusted mean changes shown in table) for all other continuous variables; Cochran–Mantel–Haenszel test for categorical variables; non-responder imputation used for ACR major clinical response and EULAR response variables, last observation carried forward.
ACPA, anti citrullinated peptide antibodies; ACR, American College of Rheumatology; ACRn, American College of Rheumatology Index of Improvement in Rheumatoid Arthritis; ANOVA, analysis of variance; DAS28, Disease Activity Score in 28 joints; ESR, erythrocyte sedimentation rate; EULAR, European League Against Rheumatism; HAQ-DI, Health Assessment Questionnaire-Disability Index; ITT, intent-to-treat; LDA, low disease activity; mITT, modified intent-to-treat; mTSS, Genant-modified total Sharp score; MTX, methotrexate; nc, not calculated; RF, rheumatoid factor.