ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 496

Effectiveness Of Repeated Courses Of Rituximab In RA – Results From The Cererra Collaboration

Katerina Chatzidionysiou1, Elisabeth Lie2, Evgeny Nasonov3, Galina Lukina3, Merete Lund Hetland4, Ulrik Tarp5, Karel Pavelka6, Cem Gabay7, Dan Nordström8, Helena Canhao9, Matija Tomsic10, Piet van Riel11, Juan Gomez-Reino12, Ioan Ancuta13, Tore Kvien2 and Ronald van Vollenhoven14, 1Dept of Medicine, Unit for Clinical Research Therapy. Inflammatory Diseases (ClinTrid), Karolinska Institute, Stockholm, Sweden, 2Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway, 3ARBITER, Institute of Rheumatology, Moscow, Russia, 4DANBIO, Department of Rheumatology, Copenhagen University Hospital at Glostrup, Copenhagen, Denmark, 5Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark, 6Department of Clinical and Experimental Rheumatology, Charles University, Prague, Czech Republic, 7SCQM registry, University Hospitals of Geneva, Geneva, Switzerland, 8ROB-FIN, Helsinki University Central Hospital, Helsinki, Finland, 9Rheumatology Research Unit, Rheumatology Research Unit, on behalf of the Rheumatic Diseases Portuguese Register, Instituto de Medicina Molecular, Rheumatology Research Unit, Rheumatology Research Unit, on behalf of the Rheumatic Diseases Portuguese Register, Lisbon, Portugal, 10Department of Rheumatology, BioRx.si, University Medical Centre Ljubjana, Ljubljana, Slovenia, 11Rheumatology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands, 12Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain, 13Internal Medicine, Cantacuzino Hospital, Bucharest, Romania, 14Unit for Clinical Research Therapy. Inflammatory Diseases (ClinTrid), Karolinska Institute, Stockholm, Sweden

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Rheumatoid Arthritis Treatment - Small Molecules, Biologics and Gene Therapy I

Session Type: Abstract Submissions (ACR)

Background/Purpose: Retreatment with rituximab (RTX) is common clinical practice, although several aspects regarding retreatment, such as frequency, need to be further elucidated. The aim of this study was to describe the effectiveness of repeated courses of RTX in a large observational cohort of real-life patients with RA.

Methods: Pooled data from the Collaborating European Registries for Rituximab in RA (CERERRA) project were used. Patients with RA who received at least 4 cycles with RTX were identified and included in the analysis. A covariate-adjusted mixed effects model was fitted to the longitudinal DAS28 for patients with complete covariate information, including country, sex, age, anti-CCP status, number of prior biologics and concomitant DMARD treatment.

Results: 340 patients met the eligibility criteria for these analyses. At baseline (start of RTX) the mean (SD) age was 53.5 (12.6) years and the mean (SD) disease duration was 12.1 (8.2) years. Patients were 83% females, 79% RF positive and 74% anti-CCP positive. 60% were treated with corticosteroids and 84% with concomitant DMARD. Patients had failed 2.7 (1.5) prior DMARDs and 1.1 (1.0) prior biologic agents. The baseline DAS28 was 6.0 (1.4). In figure 1 the mean fixed predicted decrease of DAS28 after the first cycle and after each retreatment (1st, 2nd and 3rd) is shown. Significant improvement in DAS28 (p<0.001) was observed for each course of RTX. Comparison between curves (based on estimated marginal means) revealed significant difference between the first cycle (0) and the fourth (3rd retreatment), p<0.0001, and borderline significant difference between first cycle and 2nd retreatment (p=0.05).


Conclusion: Repeated retreatment with RTX can lead to further clinical improvement after the first course of RTX.

Disclosure:

K. Chatzidionysiou,
None;

E. Lie,

Pfizer Inc,

5,

Roche Pharmaceuticals,

5,

Abbott Immunology Pharmaceuticals,

5,

Bristol-Myers Squibb,

5;

E. Nasonov,
None;

G. Lukina,
None;

M. L. Hetland,
None;

U. Tarp,
None;

K. Pavelka,

Roche, BMS, Pfizer, MSD, AbbVie,

8;

C. Gabay,

Roche Pharmaceuticals,

2,

Roche, Abbvie, Pfizer, UCB, BMS, MSD,

5;

D. Nordström,
None;

H. Canhao,
None;

M. Tomsic,
None;

P. van Riel,
None;

J. Gomez-Reino,
None;

I. Ancuta,
None;

T. Kvien,
None;

R. van Vollenhoven,
None.

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