ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1525

Cumulative Clinical  Response in  Rheumatoid  Arthritis Patients with  Rituximab Repeated Courses after Failure to Tumor Necrosis Factor Inhibitors in Routine Clinical Practice  

Catalin Codreanu1, Ruxandra Ionescu2, Ioan Ancuta3, Corina Mogosan4, Simona Rednic5, Paulina Ciurea6, Maria Suta7, Magda Parvu8, Andra Balanescu2, Mihai Bojinca3, Dan Nemes9, Codrina Ancuta10 and Elena Rezus11, 15 Thomas Masaryk Street, 'Dr. Ion Stoia' Clinical Center of Rheumatic Diseases, Bucharest, Romania, 2Rheumatology, Sfanta Maria Clinical Hospital, UMF Carol Davila, Bucharest, Romania, 3Internal Medicine and Rheumatology, Carol Davila University of Medicine and Pharmacy & Cantacuzino Hospital, Bucharest, Romania, 4'Dr. Ion Stoia' Clinical Center of Rheumatic Diseases, Bucharest, Romania, 5Rheumatology, University of Medicine and Pharmacy, Cluj-Napoca, Romania, 6Clinical County Hospital,Craiova, Craiova, Romania, 7317 Tomis Str. , Bl. 4A, ap. 3, Constanta Municipal Hospital, Constanta, Romania, 8Rheumatology, Colentina Clinical Hospital, Bucuresti, Romania, 9Rehabilitation and Rheumatology, ”Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania, 10G.T.Popa Center for Biomedical Research, Iasi, Romania, 11Rheumatology, Recovering Clinical Hospital, Iasi, Romania

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Title: Rheumatoid Arthritis - Small Molecules, Biologics and Gene Therapy: Novel therapies, Biosimilars, Strategies and Mechanisms in Rheumatoid Arthritis

Session Type: Abstract Submissions (ACR)

Background/Purpose

The concept of achieving tight control of rheumatoid arthritis (RA) and treating to target has been well established. It focuses on early diagnosis, aggressive treatment and regular monitoring, thus leading to positive outcomes in a significant number of patients with RA who achieve current treatment goals of low levels of disease activity (LDA) or clinical remission (REM).To observe and evaluate the treatment response (REM and LDA) to repeated courses of Rituximab (RTX)  in patients with RA treated in current practice in Romania.

Methods

In this open-label, multicenter, prospective observational study (REPEAT), patients were treated with initial (2×1000 mg IV, at 2 weeks apart) and subsequent RTX courses. Clinical assessments, including 28-joint count disease activity score (DAS 28), were performed at baseline (before RTX initiation), and after each retreatment course at 6, 12, 18, 24, 30 and 36 months. Statistical analyses were carried out using STATA SE/11 software: Kruskal-Wallis test for disease activity stages across evaluations, Cuzicks’ test for time trend along evaluations.

Results

1087 patients with active RA and inadequate response to at least one TNF inhibitor, who received an  initial RTX treatment were included. Their average age at entry was  56.2 ± 11.2 yrs (mean ± SD) and  86% were women.  929 patients (85.5%) had only one anti-TNF treatment, whereas 158 (14.5%) had more than one. Percentages of remission and LDA  are presented below. The  Kruskal-Wallis  test between evaluations was used,  P<0.0001, as well as Nptrend for trend across evaluations,  P < 0.0001.

 

Time  Evaluation after RTX (months)

REM

% (pts/n)

LDA

% (pts/n)

Treat to Target

% (pts/n)

6

9,43 (100/1060)

13,40 (142/1060)

22,83 (242/1060)

12

19,32 (187/968)

19,42 (188/968)

38,74 (375/968)

18

31,48 (244/775)

29,81(231/775)

61,29 (475/775)

24

41,54 (243/585)

31,28 (183/585)

72,82 (426/585)

30

44,56 (172/386)

31,87 (123/386)

76,43 (295/386)

36

51,83 (85/164)

30,49 (50/164)

82,32 (135/164)

n = patients who completed  RTX courses along evaluations

Conclusion

The data show continuous improvement of clinical response after each retreatment course with RTX. Each RTX course led to an increased and cumulative clinical response compared to the previous one, being in line with treat to target principle and EULAR/ACR recommendations.

Disclosure:

C. Codreanu,
None;

R. Ionescu,
None;

I. Ancuta,
None;

C. Mogosan,
None;

S. Rednic,
None;

P. Ciurea,
None;

M. Suta,
None;

M. Parvu,
None;

A. Balanescu,
None;

M. Bojinca,
None;

D. Nemes,
None;

C. Ancuta,
None;

E. Rezus,
None.

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