Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Assessment of Real Life Efficacy of Rituximab in Rheumatoid Arthritis: Predicting Factors of the Therapeutic Maintenance and Demonstration of a Corticosteroid Sparing Effect in the AutoImmunity and Rituximab Registry.

Gottenberg10,  Jacques-Eric, Ravaud4,  Philippe, Bardin6,  Thomas, Cacoub5,  Patrice, Cantagrel11,  Alain, Combe8,  Bernard, Dougados2,  Maxime

Bordeaux Hospital
Strasbourg Hospital
Toulouse Hospital
Cochin Hospital
Henri Mondor Hospital
Hotel Dieu Hospital
La Pitié Hospital
Lariboisière Hospital
Lille Hospital
Montpellier Hospital
Rouen Hospital

Objectives:

Registries might provide useful information on efficacy of biological agents, provided that the selected outcome criteria take into account the variability of the follow-up of hundreds of patients among a large number of centers. We therefore evaluated the real life efficacy of rituximab (RTX) in rheumatoid arthritis (RA) by analyzing its maintenance and its corticosteroid sparing effect.

Patients and Methods:

The French Society of Rheumatology has developed an independent registry, named AutoImmunity and Rituximab (AIR), available on-line (www.air-cri.org), in which data of tolerance and efficacy of RTX in refractory RA and also other refractory autoimmune diseases are prospectively collected every 6 months during 5 years.

Results:

- Predicting factors of retreatment with RTX

Among the 2005 patients with RA included in AIR registry (median age: 58 years, median RA duration: 13 years), 1057 patients (52.9%) have been retreated by RTX (2 cycles: 570, 3 cycles: 273, 4 cycles: 141, 5 cycles or more: 73).

570 patients have a follow-up of at least 18 months, including 459 patients (80.5%) who were retreated by subsequent cycles of RTX and 111 patients (19.5%) who received only one cycle before RTX discontinuation, as indicated in the crf and/or by the initiation of a new biological DMARD. RTX was discontinued because of absence of efficacy (n= 92) or problem of safety (n= 19). On univariate analysis, a higher proportion of retreated patients had not received any previous TNF antagonists (22% versus 13.7% in patients who received a single cycle, P=0.05), were RF-positive (82.1 vs 66.3%, P= 0.001) or anti-CCP positive (80.2% vs 61.7%, P<0.0001) or were RF or anti-CCP positive (91.9% vs 77.4%, P=0.04). In multivariate analysis, retreatment with RTX was significantly associated with anti-CCP positivity.

- Corticosteroid sparing effect

The proportion of patients treated with oral corticosteroids decreased from 79.1% at cycle 1 to 73.9% at cycle 2, 69.2% at cycle 3 and 69.4% at cycle 4 (P< 0.0001). Median dosage of corticosteroid decreased from 10.0 mg at 1st cycle to 6.0 mg at cycle 2, and 5.0 mg at cycle 3 and cycle 4 (P< 0.0001).

Conclusion:

These results from the AIR registry show that anti-CCP positivity is a predicting factor of therapeutic maintenance in real life. These data also demonstrate the corticosteroid sparing effect of RTX in patients with RA.

To cite this abstract, please use the following information:
Gottenberg, Jacques-Eric, Ravaud, Philippe, Bardin, Thomas, Cacoub, Patrice, Cantagrel, Alain, Combe, Bernard, et al; Assessment of Real Life Efficacy of Rituximab in Rheumatoid Arthritis: Predicting Factors of the Therapeutic Maintenance and Demonstration of a Corticosteroid Sparing Effect in the AutoImmunity and Rituximab Registry. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1790
DOI: 10.1002/art.29555

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