Sustained Response to Repeat Rituximab Seen in RA

Similar effect from various doses, though highest dose may be slightly better

MONDAY, Aug. 23 (HealthDay News) -- Three rituximab (RTX) dosing regimens have similar efficacy for rheumatoid arthritis that is no longer responding to methotrexate, and retreatment after 24 weeks results in a more sustained response through to 48 weeks, according to a study in the September issue of Rheumatology.

Andrea Rubbert-Roth, M.D., of the University of Cologne in Germany, and colleagues conducted a randomized study of the efficacy and safety of three different regimens of RTX for active rheumatoid arthritis despite being on a stable methotrexate regimen. Patients were randomized to receive two doses of RTX at baseline and at 24 months in one of three groups: 2 × 500 mg and 2 × 500 mg; 2 × 500 mg and 2 × 1000 mg (dose escalation group); and 2 × 1000 mg and 2 × 1000 mg.

The researchers found no significant differences between the treatment groups in ACR20 response at Week 48. The 2 × 1000 mg regimen was associated with a higher proportion of patients who maintained or improved their Week 24 responses at Week 48. There was no significant improvement associated with dose escalation in the 2 × 500 mg to 2 × 1000 mg regimen compared to the 2 × 500 mg and 2 × 500 mg regimen. Safety was comparable across treatment groups.

"Although RTX doses and retreatment regimens could not be clearly differentiated, several efficacy outcomes favored treatment with RTX 2 × 1000 mg. Repeat treatment at Week 24 with RTX maintained the response achieved with the first course and may be associated with improved efficacy outcomes," the authors write.

F. Hoffmann-La Roche, Biogen Idec, and Genentech sponsored the study. Several authors disclosed financial relationships with medical device and/or pharmaceutical companies, including Roche.

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