Long-term persistence with rituximab in patients with rheumatoid arthritis

Abstract Objectives To investigate the long term persistence of rituximab (RTX) in a large observational RA cohort, investigate persistence of RTX when used as a first or second line biologic DMARD (bDMARD), to characterize subsequent bDMARD treatment following RTX. Methods Patients with RA starting...

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Bibliographic Details
Published in:Rheumatology (Oxford, England) England), 2018-06, Vol.57 (6), p.1089-1096
Main Authors: Oldroyd, Alexander G S, Symmons, Deborah P M, Sergeant, Jamie C, Kearsley-Fleet, Lianne, Watson, Kath, Lunt, Mark, Hyrich, Kimme L
Format: Article
Language:English
Subjects:
Clinical Science
Immunotherapy
Monoclonal antibodies
Rheumatoid arthritis
Rituximab
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Summary:Abstract Objectives To investigate the long term persistence of rituximab (RTX) in a large observational RA cohort, investigate persistence of RTX when used as a first or second line biologic DMARD (bDMARD), to characterize subsequent bDMARD treatment following RTX. Methods Patients with RA starting treatment with RTX (MabThera) between 2008 and 2011 were recruited into the British Society for Rheumatology Biologics Register for RA. Duration of RTX treatment over the first 4 years after initiation was estimated via Kaplan-Meier estimates and the reason for discontinuation was ascertained. Subsequent bDMARD use following RTX discontinuation was characterised. Treatment survival in bDMARD-naïve (first line RTX use) and experienced (second line RTX use) cohorts was described. Results One thousand six hundred and twenty-nine patients were recruited (1371 bDMARD-experienced and 258 bDMARD-naïve). Sixty percent of the whole cohort remained on RTX after 4 years. Ineffectiveness (46%) and death (24%) were the most common reason for RTX discontinuation. RTX discontinuation was associated with RF negativity for the bDMARD-experienced cohort. Of those that discontinued RTX, 46% initiated treatment with another bDMARD, with tocilizumab being the most common. Conclusion This large study of patients initiating RTX treatment for severe RA found that 60% persisted with treatment after 4 years. This study also identified that RTX is tolerated well when used as a first or second line bDMARD.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/key036