Trial reportRheumatology (Oxford, England)2011
Retreatment with rituximab based on a treatment-to-target approach provides better disease control than treatment as needed in patients with rheumatoid arthritis: a retrospective pooled analysis.
Trial report in Rheumatology (Oxford, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Updated consensus statement on the use of rituximab in patients with rheumatoid arthritis.Annals of the rheumatic diseases · 2011Pooled it
- Induction of long-term B-cell depletion in refractory rheumatoid arthritis patients preferentially affects autoreactive more than protective humoral immunity.Arthritis research & therapy · 2012Trial
- Efficacy and safety of various repeat treatment dosing regimens of rituximab in patients with active rheumatoid arthritis: results of a Phase III randomized study (MIRROR).Rheumatology (Oxford, England) · 2010Trial
- Treat-to-target vs fixed interval retreatment strategy with rituximab in rheumatoid arthritis: a retrospective cohort study.Rheumatology international · 2024Article
- Article
- To flare or not to flare: patients' and rheumatologists' perceptions on the on-flare retreatment strategy of rituximab in rheumatoid arthritis.Therapeutic advances in musculoskeletal disease · 2024Article
- Cost-effectiveness analysis of treatment sequences containing tofacitinib for the treatment of rheumatoid arthritis in Spain.Clinical rheumatology · 2020Article
- Rituximab in routine care of severe active rheumatoid arthritis : A prospective, non-interventional study in Germany.Zeitschrift fur Rheumatologie · 2019Article
- Repeated low-dose rituximab treatment based on the assessment of circulating B cells in patients with refractory myasthenia gravis.Therapeutic advances in neurological disorders · 2019Article
- bDMARD Dose Reduction in Rheumatoid Arthritis: A Narrative Review with Systematic Literature Search.Rheumatology and therapy · 2017Review
- Targeting B cells in relapsing-remitting multiple sclerosis: from pathophysiology to optimal clinical management.Therapeutic advances in neurological disorders · 2017Review
- Rituximab for Rheumatoid Arthritis.Rheumatology and therapy · 2015Review
- Spanish Rheumatology Society and Hospital Pharmacy Society Consensus on recommendations for biologics optimization in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis.Rheumatology (Oxford, England) · 2015Article
- [B cell therapy of rheumatoid arthritis with rituximab. Practice-relevant aspects for the routine].Zeitschrift fur Rheumatologie · 2015Review
- Efficacy and safety of rituximab as maintenance therapy for relapsing granulomatosis with polyangiitis—a case series.Clinical rheumatology · 2014Article
- [Recommendations for use of rituximab in patients with rheumatoid arthritis].Zeitschrift fur Rheumatologie · 2014Article
- B-cell depletion in SLE: clinical and trial experience with rituximab and ocrelizumab and implications for study design.Arthritis research & therapy · 2013Review
- Rituximab in the treatment of pemphigus vulgaris.Dermatology and therapy · 2012Article
- Living life without B cells: is repeated B-cell depletion a safe and effective long-term treatment plan for rheumatoid arthritis?International journal of clinical rheumatology · 2012Article
- Safety and clinical outcomes of rituximab therapy in patients with different autoimmune diseases: experience from a national registry (GRAID).Arthritis research & therapy · 2011Article
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo assess the efficacy and safety profiles of two different rituximab retreatment regimens in patients with RA.
methodsFour hundred and ninety-three RA patients with an inadequate response to MTX recruited into rituximab Phase II/III studies received further courses of open-label rituximab based on two approaches: (i) treatment to target (TT): patients assessed 24 weeks after each course and retreated if not in remission [DAS in 28 joints based on ESR (DAS-28-ESR) ≥ 2.6]; (ii) treatment as needed (PRN): patients retreated at the physician's discretion ≥24 weeks following the first course and ≥16 weeks following further courses, if both swollen and tender joint counts were ≥8. All courses consisted of i.v. rituximab 2 × 1000 mg 2 weeks apart plus MTX. Observed data were analysed according to treatment strategy.
resultsMultiple courses of rituximab maintained or improved responses irrespective of regimen. TT provided tighter control of disease activity with significantly greater improvements in DAS-28-ESR and lower HAQ-disability index scores vs PRN. TT resulted in significantly more patients achieving major clinical response. PRN resulted in recurrence of disease symptoms between courses, with TT significantly reducing the incidence of RA flares. Despite more frequent retreatment with TT compared with PRN, the rates of serious adverse events and serious infections were comparable between regimens.
conclusionsRetreatment with rituximab based on 24-week evaluations and to a target of DAS-28-ESR remission leads to improved efficacy and tighter control of disease activity compared with PRN without a compromised safety profile. TT may be the preferable rituximab treatment regimen for patients with RA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.