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AMSTERDAM — For the first time, rituximab has been shown to prevent the progression of joint damage—a critical therapeutic outcome—in patients with long-standing, intractable rheumatoid arthritis, Dr. Edward Keystone said at the annual European Congress of Rheumatology.
“This is the first time we've seen an agent that can inhibit radiographic progression after the failure of tumor necrosis factor blockade,” said Dr. Keystone. Some 25%–40% of patients do not respond to tumor necrosis factor-αinhibitors.
In a double-blind trial that included 517 patients whose mean disease duration was 12 years, the mean change in total Sharp score from baseline was 2.31 among patients randomized to placebo plus methotrexate (10–25 mg/week) after 1 year of follow-up.
In contrast, among those receiving two infusions of rituximab, 1 g 2 weeks apart, plus background methotrexate, the mean change in Sharp score was 1, said Dr. Keystone, a professor of medicine at the University of Toronto. Mean changes in erosion scores were 1.32 and 0.59 in the placebo and rituximab groups, respectively, while mean changes in joint space narrowing were 0.99 and 0.41.
These differences were statistically significant and represented a 50% reduction in radiographic progression, he said at the meeting, sponsored by the European League Against Rheumatism.
Of the patients receiving rituximab, 61% had no change in erosion score from baseline, as did 52% of those receiving only methotrexate.
Clinical efficacy also was maintained among patients receiving rituximab, with 51%, 27%, and 12% of patients achieving ACR 20, 50, and 70 responses, respectively, according to Dr. Keystone.
The average time to flare was 30 weeks.
Rituximab is a selective inhibitor of CD20+ B cells. Its administration results in depletion of this subset of B cells, possibly through cell-mediated and complement-dependent mechanisms.
AMSTERDAM — For the first time, rituximab has been shown to prevent the progression of joint damage—a critical therapeutic outcome—in patients with long-standing, intractable rheumatoid arthritis, Dr. Edward Keystone said at the annual European Congress of Rheumatology.
“This is the first time we've seen an agent that can inhibit radiographic progression after the failure of tumor necrosis factor blockade,” said Dr. Keystone. Some 25%–40% of patients do not respond to tumor necrosis factor-αinhibitors.
In a double-blind trial that included 517 patients whose mean disease duration was 12 years, the mean change in total Sharp score from baseline was 2.31 among patients randomized to placebo plus methotrexate (10–25 mg/week) after 1 year of follow-up.
In contrast, among those receiving two infusions of rituximab, 1 g 2 weeks apart, plus background methotrexate, the mean change in Sharp score was 1, said Dr. Keystone, a professor of medicine at the University of Toronto. Mean changes in erosion scores were 1.32 and 0.59 in the placebo and rituximab groups, respectively, while mean changes in joint space narrowing were 0.99 and 0.41.
These differences were statistically significant and represented a 50% reduction in radiographic progression, he said at the meeting, sponsored by the European League Against Rheumatism.
Of the patients receiving rituximab, 61% had no change in erosion score from baseline, as did 52% of those receiving only methotrexate.
Clinical efficacy also was maintained among patients receiving rituximab, with 51%, 27%, and 12% of patients achieving ACR 20, 50, and 70 responses, respectively, according to Dr. Keystone.
The average time to flare was 30 weeks.
Rituximab is a selective inhibitor of CD20+ B cells. Its administration results in depletion of this subset of B cells, possibly through cell-mediated and complement-dependent mechanisms.
AMSTERDAM — For the first time, rituximab has been shown to prevent the progression of joint damage—a critical therapeutic outcome—in patients with long-standing, intractable rheumatoid arthritis, Dr. Edward Keystone said at the annual European Congress of Rheumatology.
“This is the first time we've seen an agent that can inhibit radiographic progression after the failure of tumor necrosis factor blockade,” said Dr. Keystone. Some 25%–40% of patients do not respond to tumor necrosis factor-αinhibitors.
In a double-blind trial that included 517 patients whose mean disease duration was 12 years, the mean change in total Sharp score from baseline was 2.31 among patients randomized to placebo plus methotrexate (10–25 mg/week) after 1 year of follow-up.
In contrast, among those receiving two infusions of rituximab, 1 g 2 weeks apart, plus background methotrexate, the mean change in Sharp score was 1, said Dr. Keystone, a professor of medicine at the University of Toronto. Mean changes in erosion scores were 1.32 and 0.59 in the placebo and rituximab groups, respectively, while mean changes in joint space narrowing were 0.99 and 0.41.
These differences were statistically significant and represented a 50% reduction in radiographic progression, he said at the meeting, sponsored by the European League Against Rheumatism.
Of the patients receiving rituximab, 61% had no change in erosion score from baseline, as did 52% of those receiving only methotrexate.
Clinical efficacy also was maintained among patients receiving rituximab, with 51%, 27%, and 12% of patients achieving ACR 20, 50, and 70 responses, respectively, according to Dr. Keystone.
The average time to flare was 30 weeks.
Rituximab is a selective inhibitor of CD20+ B cells. Its administration results in depletion of this subset of B cells, possibly through cell-mediated and complement-dependent mechanisms.