Session Information
Date: Sunday, November 8, 2015
Title: Rheumatoid Arthritis - Small Molecules, Biologics and Gene Therapy Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Rituximab is an anti-CD20 antibody that represents a therapeutic alternative for the patients with rheumatoid arthritis. It has been proven that rituximab at a dose of 2 gm is very effective in patients with DMARD and antiTNF failures. But the cost of this therapy is high and increases the economic burden. Limited data has shown that B cell is possible even with lower dosage to what is recommended.
Methods: In this open label, prospective, observational study at tertiary care center sero positive RA patients who responded inadequately to combination of DMARD, were given single dose of 100 mg of rituximab. B cell numbers in the peripheral blood was assessed by Flow cytometry and B cell depletion was defined as B cell numbers < 0.01 %.Efficacy was evaluated using B cell depletion after 2 weeks and disease activity score in 28 joints (DAS28) on monthly bases. Those patients who did not achieve EULAR moderate response were given second dose of rituximab 500mg.
Results: : 14 patients(12 females and 2 males; mean age 47 ± 7.1years) were included in the study. Mean duration of the disease was 8 ± 6.8 years .RF was positive in 13 out of 14 and Anti CCP antibody was positive in all patients. At baseline mean DAS score was 6.2 ± 0.79 and mean CD 19 % was 11.03 ± 4.53%. After 2 weeks of rituximab, B cell depletion was achieved in 11 patients (79%) and mean DAS28 was 2.86 ± 0.84 at the end of 24 weeks. Two patients were given second dose of 500mg rituximab after 8 weeks of first dose. Out of 14 patients, 8 achieved good EULAR response and 6 achieved moderate EULAR response. At 24 weeks ,7 (50%) patients were in remission.
Conclusion: : Early results from this study are very promising and show that low dose rituximab is effective in treating RA patients with inadequate response to DMARD.
To cite this abstract in AMA style:
Shenoy P, Bavaliya M. Efficacy of Very Low Dose (100mg) Rituximab in Active Rheumatoid Arthritis Despite Combination DMARD-Single Center, Prospective, Observational Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/efficacy-of-very-low-dose-100mg-rituximab-in-active-rheumatoid-arthritis-despite-combination-dmard-single-center-prospective-observational-study/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/efficacy-of-very-low-dose-100mg-rituximab-in-active-rheumatoid-arthritis-despite-combination-dmard-single-center-prospective-observational-study/