SINGLE CENTRE EXPERIENCE USING RITUXIMAB TO TREAT PATIENTS WITH RHEUMATOID ARTHRITIS ALREADY ON METHOTREXATE THERAPY

Abstract

Objective: To find out the efficacy and safety of rituximab in the treatment of
rheumatoid arthritis (RA) already receiving methotrexate therapy.
Methodology: This retrospective review of data was conducted in the Department
of Medicine and Rheumatology of Lady Reading hospital, Peshawar.
The study included 65 patients from July 2014 to November 2015. Data of
patients with RA of more than one year duration and who were refractory to
traditional disease modifying drugs were included with a DAS-28 score of 5.1
or more. Patients below 15 years of age and beyond 60 were excluded.
Results: The mean age of the patients was 35.95±12.74 and ranged from 16
to 58 years. Females were 44 (78%). DAS 28 at the start of treatment ranged
from 5.1 to 6.8 (mean 5.7±0.46). DAS 28 after 3 months ranged from 1-5.5
(mean 2.8±0.3). About 63% patients showed full response. Response was
more evident in females as compared to males. Allergic reactions to the drug
were observed in 3 patients. Overall adverse reactions in the form of leukopenia,
thrombocytopenia, oral ulcers and diarrhea were observed in 1.5-9% of
patients. Severe anemia was seen in only 7.7%.
Conclusion: Rituximab has shown to be an effective and safe addition in patients
with rheumatoid arthritis who are refractory to the standard treatment.