The efficacy and safety of rituximab for the treatment of active rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials

Young Ho Lee, Sang Cheol Bae, Gwan Gyu Song

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    62 Citations (Scopus)

    Abstract

    The aims of this study were to assess the efficacy and safety of rituximab in patients with active rheumatoid arthritis (RA). The authors surveyed randomized controlled trials (RCTs) that examined the efficacy of rituximab in disease modifying anti-rheumatic drug (DMARD) (including methotrexate [MTX]) or tumor necrosis factor (TNF)-blocker-resistant or intolerant patients with active RA using Medline, the Cochrane Controlled Trials Register, and manual searches. Meta-analysis of RCTs was performed to determine the treatment efficacy and safety outcomes of rituximab (1 course, consisting of two infusions of 1,000 mg each) concomitant with MTX. The three RCTs included 938 DMARD or TNF-blocker-resistant or intolerant RA patients. Follow-up periods ranged from 24 to 48 weeks. American College of Rheumatology response (ACR) 20, ACR50, and ACR70 response rates were significantly higher for the rituximab plus MTX than for placebo controls (primary efficacy outcome, ACR50; risk ratio [RR] 3.648, 95% confidence interval [CI] 2.478-5.369, P < 0.001). For those treated with rituximab, the incidence adverse events of all systems were not higher than in those treated with placebo (RR 1.062, 95% CI 0.912-1.236, P = 0.438). With respect to the number of patients that experienced at least one serious adverse event, no significant difference was observed between patients treated with rituximab and placebo (RR 0.855, 95% CI 0.622-1.174, P = 0.333). A single course of rituximab with concomitant MTX therapy was found to be effective in DMARD or TNF-blocker-resistant or intolerant patients with active RA.

    Original languageEnglish
    Pages (from-to)1493-1499
    Number of pages7
    JournalRheumatology International
    Volume31
    Issue number11
    DOIs
    Publication statusPublished - 2011 Nov

    Bibliographical note

    Funding Information:
    Acknowledgments This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare and Family Affairs, Republic of Korea (A084794).

    Keywords

    • Efficacy
    • Rheumatoid arthritis
    • Rituximab
    • Safety

    ASJC Scopus subject areas

    • Rheumatology
    • Immunology and Allergy
    • Immunology

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