Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration

Katerina Chatzidionysiou; Elisabeth Lie; Evgeny Nasonov; Galina Lukina; Merete Lund Hetland; Ulrik Tarp; Piet L C M van Riel; Dan C Nordström; Juan Gomez-Reino; Karel Pavelka; Matija Tomsic; Tore K Kvien; Ronald F van Vollenhoven; Cem Gabay

doi:10.1136/annrheumdis-2011-200003

Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration

Katerina Chatzidionysiou, Elisabeth Lie, Evgeny Nasonov, Galina Lukina, Merete Lund Hetland, Ulrik Tarp, Piet L C M van Riel, Dan C Nordström, Juan Gomez-Reino, Karel Pavelka, Matija Tomsic, Tore K Kvien, Ronald F van Vollenhoven, Cem Gabay

Department of Clinical Medicine

56 Citations (Scopus)

Abstract

OBJECTIVES: To compare the effectiveness and safety of rituximab alone or in combination with either methotrexate or leflunomide.METHODS: 10 European registries submitted anonymised datasets with baseline, 3, 6, 9 and 12-month clinical data from patients who started rituximab.RESULTS: 1195 patients were treated with rituximab plus methotrexate, 177 with rituximab plus leflunomide and 505 with rituximab alone. Significantly more patients achieved a European League Against Rheumatism good response at 6 months when treated with rituximab plus leflunomide (29.1%) compared with rituximab plus methotrexate (21.1%) and rituximab alone (19.3%; p=0.02 and p=0.01, respectively). Similar results were observed at 12 months. Adverse events occurred in 10.2%, 13.2% and 13.9% of patients on rituximab plus leflunomide, rituximab plus methotrexate and rituximab alone, respectively.CONCLUSIONS: Leflunomide is an effective and safe alternative to methotrexate as concomitant treatment with rituximab. Slightly better results were obtained by the combination of rituximab and leflunomide than rituximab and methotrexate, raising the possibility of a synergistic effect of leflunomide and rituximab.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	71
Issue number	3
Pages (from-to)	374-377
Number of pages	4
ISSN	0003-4967
DOIs	https://doi.org/10.1136/annrheumdis-2011-200003
Publication status	Published - Mar 2012

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Chatzidionysiou, K., Lie, E., Nasonov, E., Lukina, G., Hetland, M. L., Tarp, U., van Riel, P. L. C. M., Nordström, D. C., Gomez-Reino, J., Pavelka, K., Tomsic, M., Kvien, T. K., van Vollenhoven, R. F., & Gabay, C. (2012). Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration. Annals of the Rheumatic Diseases, 71(3), 374-377. https://doi.org/10.1136/annrheumdis-2011-200003

Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration. / Chatzidionysiou, Katerina; Lie, Elisabeth; Nasonov, Evgeny et al.

In: Annals of the Rheumatic Diseases, Vol. 71, No. 3, 03.2012, p. 374-377.

Research output: Contribution to journal › Journal article › Research › peer-review

Chatzidionysiou, K, Lie, E, Nasonov, E, Lukina, G, Hetland, ML, Tarp, U, van Riel, PLCM, Nordström, DC, Gomez-Reino, J, Pavelka, K, Tomsic, M, Kvien, TK, van Vollenhoven, RF & Gabay, C 2012, 'Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration', Annals of the Rheumatic Diseases, vol. 71, no. 3, pp. 374-377. https://doi.org/10.1136/annrheumdis-2011-200003

Chatzidionysiou K, Lie E, Nasonov E, Lukina G, Hetland ML, Tarp U et al. Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration. Annals of the Rheumatic Diseases. 2012 Mar;71(3):374-377. doi: 10.1136/annrheumdis-2011-200003

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title = "Effectiveness of disease-modifying antirheumatic drug co-therapy with methotrexate and leflunomide in rituximab-treated rheumatoid arthritis patients: results of a 1-year follow-up study from the CERERRA collaboration",

abstract = "OBJECTIVES: To compare the effectiveness and safety of rituximab alone or in combination with either methotrexate or leflunomide.METHODS: 10 European registries submitted anonymised datasets with baseline, 3, 6, 9 and 12-month clinical data from patients who started rituximab.RESULTS: 1195 patients were treated with rituximab plus methotrexate, 177 with rituximab plus leflunomide and 505 with rituximab alone. Significantly more patients achieved a European League Against Rheumatism good response at 6 months when treated with rituximab plus leflunomide (29.1%) compared with rituximab plus methotrexate (21.1%) and rituximab alone (19.3%; p=0.02 and p=0.01, respectively). Similar results were observed at 12 months. Adverse events occurred in 10.2%, 13.2% and 13.9% of patients on rituximab plus leflunomide, rituximab plus methotrexate and rituximab alone, respectively.CONCLUSIONS: Leflunomide is an effective and safe alternative to methotrexate as concomitant treatment with rituximab. Slightly better results were obtained by the combination of rituximab and leflunomide than rituximab and methotrexate, raising the possibility of a synergistic effect of leflunomide and rituximab.",

author = "Katerina Chatzidionysiou and Elisabeth Lie and Evgeny Nasonov and Galina Lukina and Hetland, {Merete Lund} and Ulrik Tarp and {van Riel}, {Piet L C M} and Nordstr{\"o}m, {Dan C} and Juan Gomez-Reino and Karel Pavelka and Matija Tomsic and Kvien, {Tore K} and {van Vollenhoven}, {Ronald F} and Cem Gabay",

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AU - Chatzidionysiou, Katerina

AU - Lie, Elisabeth

AU - Nasonov, Evgeny

AU - Lukina, Galina

AU - Hetland, Merete Lund

AU - Tarp, Ulrik

AU - van Riel, Piet L C M

AU - Nordström, Dan C

AU - Gomez-Reino, Juan

AU - Pavelka, Karel

AU - Tomsic, Matija

AU - Kvien, Tore K

AU - van Vollenhoven, Ronald F

AU - Gabay, Cem

PY - 2012/3

Y1 - 2012/3

N2 - OBJECTIVES: To compare the effectiveness and safety of rituximab alone or in combination with either methotrexate or leflunomide.METHODS: 10 European registries submitted anonymised datasets with baseline, 3, 6, 9 and 12-month clinical data from patients who started rituximab.RESULTS: 1195 patients were treated with rituximab plus methotrexate, 177 with rituximab plus leflunomide and 505 with rituximab alone. Significantly more patients achieved a European League Against Rheumatism good response at 6 months when treated with rituximab plus leflunomide (29.1%) compared with rituximab plus methotrexate (21.1%) and rituximab alone (19.3%; p=0.02 and p=0.01, respectively). Similar results were observed at 12 months. Adverse events occurred in 10.2%, 13.2% and 13.9% of patients on rituximab plus leflunomide, rituximab plus methotrexate and rituximab alone, respectively.CONCLUSIONS: Leflunomide is an effective and safe alternative to methotrexate as concomitant treatment with rituximab. Slightly better results were obtained by the combination of rituximab and leflunomide than rituximab and methotrexate, raising the possibility of a synergistic effect of leflunomide and rituximab.

AB - OBJECTIVES: To compare the effectiveness and safety of rituximab alone or in combination with either methotrexate or leflunomide.METHODS: 10 European registries submitted anonymised datasets with baseline, 3, 6, 9 and 12-month clinical data from patients who started rituximab.RESULTS: 1195 patients were treated with rituximab plus methotrexate, 177 with rituximab plus leflunomide and 505 with rituximab alone. Significantly more patients achieved a European League Against Rheumatism good response at 6 months when treated with rituximab plus leflunomide (29.1%) compared with rituximab plus methotrexate (21.1%) and rituximab alone (19.3%; p=0.02 and p=0.01, respectively). Similar results were observed at 12 months. Adverse events occurred in 10.2%, 13.2% and 13.9% of patients on rituximab plus leflunomide, rituximab plus methotrexate and rituximab alone, respectively.CONCLUSIONS: Leflunomide is an effective and safe alternative to methotrexate as concomitant treatment with rituximab. Slightly better results were obtained by the combination of rituximab and leflunomide than rituximab and methotrexate, raising the possibility of a synergistic effect of leflunomide and rituximab.

U2 - 10.1136/annrheumdis-2011-200003

DO - 10.1136/annrheumdis-2011-200003

M3 - Journal article

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SP - 374

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JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

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