Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


12 Month-Retrospective Analysis of Two Different Rituximab Retreatment Regimens in Rheumatoid Arthritis: Retreatment At Clinical Relapse Vs 6th Month Fixed Retreatment.

Quartuccio1,  Luca, Schiavon2,  Franco, Biasi3,  Domenico, Carraro2,  Valeria, Ravagnani4,  Viviana, Forno4,  Ilaria Dal, Masolini1,  Paola

Rheumatology Clinic, DSMB, University of Udine, Udine, Italy
Rheumatology Clinic, University of Padova, Padova, Italy
Rheumatology Unit, University of Verona, Verona, Italy
Rheumatology Clinic, University of Verona, Verona, Italy
Rheumatology Unit, University of Padova, Padova, Italy

Background/Purpose:

to describe two treatment regimens, retreatment at clinical relapse or fixed retreatment at 6th month with rituximab in rheumatoid arthritis (RA), focusing on clinical efficacy and costs at month +12.

Methods:

76 longstanding RA patients treated with rituximab at standard dose of 1 g ×2 were studied; 47 patients were retreated with rituximab (1 g ×2) at clinical relapse (retreatment at relapse group, ReR group), while 29 patients were retreated (rituximab 1 g ×2) at the end of the 6th month after the first standard cycle of rituximab (6 month fixed retreatment group, 6-R group). There were not differences as concerns the age and sex distribution between the two groups.

Results:

There were significant differences as concerns the number of patients anti-TNF naïve (ReR>6-R, p=0.04), baseline DAS28 (ReR>6-R, p=0.01) and baseline HAQ (6-R>ReR, p<0.0001).

No differences were observed between the two groups as concerns DAS28 (p=0.6), EULAR moderate/good (ReR vs 6-R: 34/47 vs 20/29 (p=0.8), and ACRn response (ReR vs 6-R, 37/47 vs 26/29, p=0.3) at month +12.

Baseline HAQ was statistically associated with both EULAR good response [p=0.004 (OR 0.3, CI95% 0.1–0.7)], and ACR>=50 response at month +12 [p=0.001 (OR 0.3, CI95% 0.2–0.6)], independently from the retreatment regimen employed, by multivariate analysis.

Globally, a significant increase in utility (QoL) at month +12 vs baseline (p>0.0001) was observed, with mean QALY of 0.35 at month +12. Mean QALY at month+12 was 0.44 and 0.25 in ReR and 6-R group, respectively (p=0.01). A major QALY gain was observed in 6-R group than in ReR group (0.13 vs 0.07, p=0.006). Cost/QALY gain at month +12 was similar (p=1.0).

Conclusion:

In RA patients, the identification of the best rituximab retreatment regimen remains an open question. Patients in the ReR group were more often TNF naïve, had a lower HAQ and higher DAS28. Similar results may be obtained with less intensive retreatment regimen in the first 12 months (i.e., retreatment at clinical relapse) in patients 1) naïve for TNF inhibitors, 2) with lower disability and 3) with higher disease activity.

To cite this abstract, please use the following information:
Quartuccio, Luca, Schiavon, Franco, Biasi, Domenico, Carraro, Valeria, Ravagnani, Viviana, Forno, Ilaria Dal, et al; 12 Month-Retrospective Analysis of Two Different Rituximab Retreatment Regimens in Rheumatoid Arthritis: Retreatment At Clinical Relapse Vs 6th Month Fixed Retreatment. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2221
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