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Longterm followup of rituximab therapy in patients with rheumatoid arthritis: results from the Belgian MabThera in Rheumatoid Arthritis registry

Filip De Keyser UGent, Ilse Hoffman, Patrick Durez, Marie-Joëlle Kaiser and R Westhovens (2014) JOURNAL OF RHEUMATOLOGY. 41(9). p.1761-1765
abstract
Objective. Our study reports the results of the MIRA (MabThera In Rheumatoid Arthritis) registry, set up to collect data about clinical usage, patient profile, and retention of rituximab (RTX) treatment in daily clinical practice in Belgium. Methods. Patients with active rheumatoid arthritis (RA) who failed at least 1 anti-tumor necrosis factor (anti-TNF) treatment were included in our study between November 2006 and October 2011. At baseline, demographics, medication, disease history, disease activity, rheumatoid factor (RF), and anticyclic citrullinated peptide antibodies (anti-CCP) status were recorded. Evolution of the 28-joint Disease Activity Score (DAS28)-erythrocyte sedimentation rate, retreatments, and reasons for therapy stop were followed prospectively. Results. The MIRA registry included 649 patients, with mean disease duration of 12.8 +/- 0.4 years and DAS28 values at inclusion of 5.85 +/- 0.48. Patients received on average 2.82 +/- 0.07 (range 1-9) RTX treatments, over a mean followup period of 93.1 +/- 2.6 weeks. At database lock, 433 patients (66.7%) were still under RTX treatment, 182 (28.0%) had stopped treatment, and 34 (5.2%) were lost to followup. Ineffectiveness (n = 108, 59%) and safety concerns (n = 39, 22%) were the most frequent reasons for discontinuing RTX therapy. From 2006 to 2011, RTX practice patterns clearly evolved toward RTX being started in patients with a lower number of previously failed anti-TNF drugs and lower baseline DAS28 values. A lower number of previous anti-TNF drugs, and positivity for RF and anti-CCP, predicted more successful longterm treatment. RTX treatment provided adequate longterm disease control. Conclusion. In our daily practice study, RTX provided good longterm disease control and treatment retention in refractory patients with RA. Over the years, rheumatologists tended to start this treatment in patients with fewer previous anti-TNF treatments and lower disease activity.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
EFFICACY, INADEQUATE RESPONSE, SAFETY, TRIAL, DAS28, COHORT STUDY, RITUXIMAB, ANTIRHEUMATIC AGENTS, RHEUMATOID ARTHRITIS, ANTI-TNF AGENT
journal title
JOURNAL OF RHEUMATOLOGY
J. Rheumatol.
volume
41
issue
9
pages
1761 - 1765
Web of Science type
Article
Web of Science id
000341825100008
JCR category
RHEUMATOLOGY
JCR impact factor
3.187 (2014)
JCR rank
10/32 (2014)
JCR quartile
2 (2014)
ISSN
0315-162X
DOI
10.3899/jrheum.131279
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
5793446
handle
http://hdl.handle.net/1854/LU-5793446
date created
2015-01-05 10:31:30
date last changed
2016-12-19 15:43:32
@article{5793446,
  abstract     = {Objective. Our study reports the results of the MIRA (MabThera In Rheumatoid Arthritis) registry, set up to collect data about clinical usage, patient profile, and retention of rituximab (RTX) treatment in daily clinical practice in Belgium. 
Methods. Patients with active rheumatoid arthritis (RA) who failed at least 1 anti-tumor necrosis factor (anti-TNF) treatment were included in our study between November 2006 and October 2011. At baseline, demographics, medication, disease history, disease activity, rheumatoid factor (RF), and anticyclic citrullinated peptide antibodies (anti-CCP) status were recorded. Evolution of the 28-joint Disease Activity Score (DAS28)-erythrocyte sedimentation rate, retreatments, and reasons for therapy stop were followed prospectively. 
Results. The MIRA registry included 649 patients, with mean disease duration of 12.8 +/- 0.4 years and DAS28 values at inclusion of 5.85 +/- 0.48. Patients received on average 2.82 +/- 0.07 (range 1-9) RTX treatments, over a mean followup period of 93.1 +/- 2.6 weeks. At database lock, 433 patients (66.7\%) were still under RTX treatment, 182 (28.0\%) had stopped treatment, and 34 (5.2\%) were lost to followup. Ineffectiveness (n = 108, 59\%) and safety concerns (n = 39, 22\%) were the most frequent reasons for discontinuing RTX therapy. From 2006 to 2011, RTX practice patterns clearly evolved toward RTX being started in patients with a lower number of previously failed anti-TNF drugs and lower baseline DAS28 values. A lower number of previous anti-TNF drugs, and positivity for RF and anti-CCP, predicted more successful longterm treatment. RTX treatment provided adequate longterm disease control. 
Conclusion. In our daily practice study, RTX provided good longterm disease control and treatment retention in refractory patients with RA. Over the years, rheumatologists tended to start this treatment in patients with fewer previous anti-TNF treatments and lower disease activity.},
  author       = {De Keyser, Filip and Hoffman, Ilse and Durez, Patrick and Kaiser, Marie-Jo{\"e}lle and Westhovens, R},
  issn         = {0315-162X},
  journal      = {JOURNAL OF RHEUMATOLOGY},
  keyword      = {EFFICACY,INADEQUATE RESPONSE,SAFETY,TRIAL,DAS28,COHORT STUDY,RITUXIMAB,ANTIRHEUMATIC AGENTS,RHEUMATOID ARTHRITIS,ANTI-TNF AGENT},
  language     = {eng},
  number       = {9},
  pages        = {1761--1765},
  title        = {Longterm followup of rituximab therapy in patients with rheumatoid arthritis: results from the Belgian MabThera in Rheumatoid Arthritis registry},
  url          = {http://dx.doi.org/10.3899/jrheum.131279},
  volume       = {41},
  year         = {2014},
}

Chicago
De Keyser, Filip, Ilse Hoffman, Patrick Durez, Marie-Joëlle Kaiser, and R Westhovens. 2014. “Longterm Followup of Rituximab Therapy in Patients with Rheumatoid Arthritis: Results from the Belgian MabThera in Rheumatoid Arthritis Registry.” Journal of Rheumatology 41 (9): 1761–1765.
APA
De Keyser, F., Hoffman, I., Durez, P., Kaiser, M.-J., & Westhovens, R. (2014). Longterm followup of rituximab therapy in patients with rheumatoid arthritis: results from the Belgian MabThera in Rheumatoid Arthritis registry. JOURNAL OF RHEUMATOLOGY, 41(9), 1761–1765.
Vancouver
1.
De Keyser F, Hoffman I, Durez P, Kaiser M-J, Westhovens R. Longterm followup of rituximab therapy in patients with rheumatoid arthritis: results from the Belgian MabThera in Rheumatoid Arthritis registry. JOURNAL OF RHEUMATOLOGY. 2014;41(9):1761–5.
MLA
De Keyser, Filip, Ilse Hoffman, Patrick Durez, et al. “Longterm Followup of Rituximab Therapy in Patients with Rheumatoid Arthritis: Results from the Belgian MabThera in Rheumatoid Arthritis Registry.” JOURNAL OF RHEUMATOLOGY 41.9 (2014): 1761–1765. Print.