UMMS Affiliation

Department of Medicine, Division of Rheumatology; Department of Orthopedics and Physical Rehabilitation; Department of Medicine, Division of Preventive and Behavioral Medicine

Date

7-1-2015

Document Type

Article

Disciplines

Rheumatology

Abstract

OBJECTIVE: To characterize the real-world effectiveness of rituximab (RTX) in patients with rheumatoid arthritis.

METHODS: Clinical effectiveness at 12 months was assessed in patients who were prescribed RTX based on the Clinical Disease Activity Index (CDAI). Change in CDAI was calculated (CDAI at 12 mos minus at initiation). Achievement of remission or low disease activity (LDA; CDAI < /= 10) among those with moderate/high disease activity at the time of RTX initiation was compared based on prior anti-tumor necrosis factor agent (anti-TNF) use (1 vs > /= 2) using logistic regression models.

RESULTS: Patients (n = 265) were followed for 12 months with a mean change in CDAI of -8.1 (95% CI -9.8 - -6.4). Of the 218 patients with moderate/high disease activity at baseline, patients with 1 prior anti-TNF (baseline CDAI 25.0) demonstrated a mean change in CDAI of -10.1 (95% CI -13.2 - -7.0); patients with > /= 2 prior anti-TNF (baseline CDAI 30.0) demonstrated a mean change of -10.5 (95% CI -12.9 - -8.0). The unadjusted OR for achieving LDA/remission in patients with moderate/high disease activity at baseline exposed to > /= 2 versus 1 prior anti-TNF was 0.40 (95% CI 0.22-0.73), which was robust to 4 different adjusted models (OR range 0.38-0.44).

CONCLUSION: A good clinical response was observed in all patients; however, patients previously treated with 1 anti-TNF, who had lower baseline CDAI and a greater opportunity for clinical improvement compared with patients previously treated with > /= 2 anti-TNF, were more likely to achieve LDA/remission.

Rights and Permissions

Citation: J Rheumatol. 2015 Jul;42(7):1090-8. doi: 10.3899/jrheum.141043. Epub 2015 May 1. Link to article on publisher's site

DOI of Published Version

10.3899/jrheum.141043

Comments

Open access and free online via JRheum Full Release option; see http://www.jrheum.com/guideforauthors.html#firstrelease.

Related Resources

Link to Article in PubMed

Keywords

antirheumatic agents, registries, rheumatoid arthritis, rituximab

Journal Title

The Journal of rheumatology

PubMed ID

25934829

Included in

Rheumatology Commons

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