%0 Journal Article
%T Rituximab is more effective than second anti-TNF therapy in rheumatoid arthritis patients and previous TNF¦Á blocker failure
%A Kekow J
%A Mueller-Ladner U
%A Schulze-Koops H
%J Biologics: Targets and Therapy
%D 2012
%I Dove Medical Press
%R http://dx.doi.org/10.2147/BTT.S32244
%X uximab is more effective than second anti-TNF therapy in rheumatoid arthritis patients and previous TNF¦Á blocker failure Original Research (2314) Total Article Views Authors: Kekow J, Mueller-Ladner U, Schulze-Koops H Published Date July 2012 Volume 2012:6 Pages 191 - 199 DOI: http://dx.doi.org/10.2147/BTT.S32244 Received: 26 March 2012 Accepted: 17 April 2012 Published: 02 July 2012 Joern Kekow,1 Ulf Mueller-Ladner,2 Hendrik Schulze-Koops3 1Clinic of Rheumatology and Orthopedics, Otto-von-Guericke University of Magdeburg, Vogelsang-Gommern; 2Department of Rheumatology and Clinical Immunology, Kerckhoff Clinic, Bad Nauheim; 3Division of Rheumatology, University of Munich, Munich, Germany Purpose: To assess the efficacy of one course of rituximab (two 1-g doses) compared to an alternative tumor necrosis factor-¦Á (TNF¦Á) blocker in rheumatoid arthritis patients who had experienced one previous TNF¦Á blocker failure (eg, etanercept, adalimumab, or infliximab). Patients and methods: The efficacy of both treatments was studied in this retrospective, multicenter, noninterventional cohort study with 196 patients. All patients had active rheumatoid arthritis defined by a Disease Activity Score-28 of ¡Ý3.2 despite having TNF¦Á blocker therapy, and were followed over 6.6 months on average after switching to rituximab versus a second TNF¦Á blocker (ie, switching to etanercept, adalimumab, or infliximab) at baseline. Results: At baseline, both cohorts showed similar demographic and disease-related characteristics (including Disease Activity Score-28). At the end of observation, mean Disease Activity Score-28 was significantly lower after treatment with rituximab than with a second TNF¦Á blocker (-1.64 [95% confidence interval: -1.92; -1.36] versus -1.19 [95% confidence interval: -1.42; -0.96], P = 0.013). This difference between the two groups was even more pronounced when patients were seropositive for rheumatoid factor (-1.66 versus -1.17, P = 0.018) and anti-cyclic citrullinated peptide antibodies (-1.75 versus -1.06, P = 0.002). More rituximab-treated patients achieved good European League Against Rheumatism response than TNF¦Á blocker-treated patients (30% versus 15%), and less patients were nonresponders (22% versus 35%) according to European League Against Rheumatism criteria (P = 0.022, chi-squared test). Conclusion: Treatment with rituximab was more effective than a second TNF¦Á blocker therapy in rheumatoid arthritis patients after failure of the first TNF¦Á blocker. It was found that anti-cyclic citrullinated peptide antibodies may be a useful predictive biomarker for response to rituximab in patients with TNF¦Á blocker treatment failure.
%K rheumatoid arthritis
%K rituximab
%K anti-cyclic citrullinated peptide antibodies
%K rheumatoid factor
%U https://www.dovepress.com/rituximab-is-more-effective-than-second-anti-tnf-therapy-in-rheumatoid-peer-reviewed-article-BTT