Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration

Katerina Chatzidionysiou; Elisabeth Lie; Galina Lukina; Merete L Hetland; Ellen-Margrethe Hauge; Karel Pavelka; Cem Gabay; Almut Scherer; Dan Nordström; Helena Canhao; Maria José Santos; Matija Tomsic; Ziga Rotar; M Victoria Hernández; Juan Gomez-Reino; Ioan Ancuta; Tore K Kvien; Ronald van Vollenhoven

doi:10.3899/jrheum.160460

Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration

Katerina Chatzidionysiou, Elisabeth Lie, Galina Lukina, Merete L Hetland, Ellen-Margrethe Hauge, Karel Pavelka, Cem Gabay, Almut Scherer, Dan Nordström, Helena Canhao, Maria José Santos, Matija Tomsic, Ziga Rotar, M Victoria Hernández, Juan Gomez-Reino, Ioan Ancuta, Tore K Kvien, Ronald van Vollenhoven

Institut for Klinisk Medicin

9 Citationer (Scopus)

Abstract

Objective. Several aspects of rituximab (RTX) retreatment in rheumatoid arthritis (RA) need to be further elucidated. The aim of this study was to describe the effect of repeated courses of RTX on disease activity and to compare 2 retreatment strategies, fixed-interval versus on-flare retreatment, in a large international, observational, collaborative study. Methods. In the first analysis, patients with RA who received at least 4 cycles with RTX were included. In the second analysis, patients who received at least 1 RTX retreatment and for whom information about the strategy for retreatment was available were identified. Two retreatment strategies (fixed-interval vs on-flare) were compared by fitting-Adjusted, mixed-effects models of 28-joint Disease Activity Score (DAS28) over time for first and second retreatment. Results.A total of 1530 patients met the eligibility criteria for the first analysis. Significant reductions of mean DAS28 between the starts of subsequent treatment cycles were observed (at start of first treatment cycle: 5.5; second: 4.3; third: 3.8; and fourth: 3.5), suggesting improved response after each additional cycle (p < 0.0001 for all pairwise comparisons). A total of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6-4.1 vs 4.6, 95% CI 4.5-4.7, p < 0.0001). Similar results were found for the second retreatment. Conclusion. Repeated treatment with RTX leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment.

Originalsprog	Engelsk
Tidsskrift	Journal of Rheumatology
Vol/bind	44
Udgave nummer	2
Sider (fra-til)	162-169
Antal sider	8
ISSN	0315-162X
DOI	https://doi.org/10.3899/jrheum.160460
Status	Udgivet - 1 feb. 2017

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10.3899/jrheum.160460

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Chatzidionysiou, K., Lie, E., Lukina, G., Hetland, M. L., Hauge, E-M., Pavelka, K., Gabay, C., Scherer, A., Nordström, D., Canhao, H., Santos, M. J., Tomsic, M., Rotar, Z., Hernández, M. V., Gomez-Reino, J., Ancuta, I., Kvien, T. K., & van Vollenhoven, R. (2017). Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration. Journal of Rheumatology, 44(2), 162-169. https://doi.org/10.3899/jrheum.160460

Chatzidionysiou, K, Lie, E, Lukina, G, Hetland, ML, Hauge, E-M, Pavelka, K, Gabay, C, Scherer, A, Nordström, D, Canhao, H, Santos, MJ, Tomsic, M, Rotar, Z, Hernández, MV, Gomez-Reino, J, Ancuta, I, Kvien, TK & van Vollenhoven, R 2017, 'Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration', Journal of Rheumatology, bind 44, nr. 2, s. 162-169. https://doi.org/10.3899/jrheum.160460

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title = "Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration",

abstract = "Objective. Several aspects of rituximab (RTX) retreatment in rheumatoid arthritis (RA) need to be further elucidated. The aim of this study was to describe the effect of repeated courses of RTX on disease activity and to compare 2 retreatment strategies, fixed-interval versus on-flare retreatment, in a large international, observational, collaborative study. Methods. In the first analysis, patients with RA who received at least 4 cycles with RTX were included. In the second analysis, patients who received at least 1 RTX retreatment and for whom information about the strategy for retreatment was available were identified. Two retreatment strategies (fixed-interval vs on-flare) were compared by fitting-Adjusted, mixed-effects models of 28-joint Disease Activity Score (DAS28) over time for first and second retreatment. Results.A total of 1530 patients met the eligibility criteria for the first analysis. Significant reductions of mean DAS28 between the starts of subsequent treatment cycles were observed (at start of first treatment cycle: 5.5; second: 4.3; third: 3.8; and fourth: 3.5), suggesting improved response after each additional cycle (p < 0.0001 for all pairwise comparisons). A total of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6-4.1 vs 4.6, 95% CI 4.5-4.7, p < 0.0001). Similar results were found for the second retreatment. Conclusion. Repeated treatment with RTX leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment.",

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author = "Katerina Chatzidionysiou and Elisabeth Lie and Galina Lukina and Hetland, {Merete L} and Ellen-Margrethe Hauge and Karel Pavelka and Cem Gabay and Almut Scherer and Dan Nordstr{\"o}m and Helena Canhao and Santos, {Maria Jos{\'e}} and Matija Tomsic and Ziga Rotar and Hern{\'a}ndez, {M Victoria} and Juan Gomez-Reino and Ioan Ancuta and Kvien, {Tore K} and {van Vollenhoven}, Ronald",

year = "2017",

month = feb,

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doi = "10.3899/jrheum.160460",

language = "English",

volume = "44",

pages = "162--169",

journal = "Journal of Rheumatology",

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TY - JOUR

T1 - Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort

T2 - Data from the CERERRA Collaboration

AU - Chatzidionysiou, Katerina

AU - Lie, Elisabeth

AU - Lukina, Galina

AU - Hetland, Merete L

AU - Hauge, Ellen-Margrethe

AU - Pavelka, Karel

AU - Gabay, Cem

AU - Scherer, Almut

AU - Nordström, Dan

AU - Canhao, Helena

AU - Santos, Maria José

AU - Tomsic, Matija

AU - Rotar, Ziga

AU - Hernández, M Victoria

AU - Gomez-Reino, Juan

AU - Ancuta, Ioan

AU - Kvien, Tore K

AU - van Vollenhoven, Ronald

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Objective. Several aspects of rituximab (RTX) retreatment in rheumatoid arthritis (RA) need to be further elucidated. The aim of this study was to describe the effect of repeated courses of RTX on disease activity and to compare 2 retreatment strategies, fixed-interval versus on-flare retreatment, in a large international, observational, collaborative study. Methods. In the first analysis, patients with RA who received at least 4 cycles with RTX were included. In the second analysis, patients who received at least 1 RTX retreatment and for whom information about the strategy for retreatment was available were identified. Two retreatment strategies (fixed-interval vs on-flare) were compared by fitting-Adjusted, mixed-effects models of 28-joint Disease Activity Score (DAS28) over time for first and second retreatment. Results.A total of 1530 patients met the eligibility criteria for the first analysis. Significant reductions of mean DAS28 between the starts of subsequent treatment cycles were observed (at start of first treatment cycle: 5.5; second: 4.3; third: 3.8; and fourth: 3.5), suggesting improved response after each additional cycle (p < 0.0001 for all pairwise comparisons). A total of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6-4.1 vs 4.6, 95% CI 4.5-4.7, p < 0.0001). Similar results were found for the second retreatment. Conclusion. Repeated treatment with RTX leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment.

AB - Objective. Several aspects of rituximab (RTX) retreatment in rheumatoid arthritis (RA) need to be further elucidated. The aim of this study was to describe the effect of repeated courses of RTX on disease activity and to compare 2 retreatment strategies, fixed-interval versus on-flare retreatment, in a large international, observational, collaborative study. Methods. In the first analysis, patients with RA who received at least 4 cycles with RTX were included. In the second analysis, patients who received at least 1 RTX retreatment and for whom information about the strategy for retreatment was available were identified. Two retreatment strategies (fixed-interval vs on-flare) were compared by fitting-Adjusted, mixed-effects models of 28-joint Disease Activity Score (DAS28) over time for first and second retreatment. Results.A total of 1530 patients met the eligibility criteria for the first analysis. Significant reductions of mean DAS28 between the starts of subsequent treatment cycles were observed (at start of first treatment cycle: 5.5; second: 4.3; third: 3.8; and fourth: 3.5), suggesting improved response after each additional cycle (p < 0.0001 for all pairwise comparisons). A total of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6-4.1 vs 4.6, 95% CI 4.5-4.7, p < 0.0001). Similar results were found for the second retreatment. Conclusion. Repeated treatment with RTX leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment.

KW - Journal Article

U2 - 10.3899/jrheum.160460

DO - 10.3899/jrheum.160460

M3 - Journal article

C2 - 28089978

SN - 0315-162X

VL - 44

SP - 162

EP - 169

JO - Journal of Rheumatology

JF - Journal of Rheumatology

IS - 2

ER -

Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration

Abstract

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