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Editorial
. 2016 Jun 2;18(1):126.
doi: 10.1186/s13075-016-1022-1.

Could we use a lower dose of rituximab to treat rheumatoid arthritis in clinical practice: pros and cons?

Gianfranco Ferraccioli  1   2 , Barbara Tolusso  3   4 , Elisa Gremese  3   4
Affiliations
Editorial

Could we use a lower dose of rituximab to treat rheumatoid arthritis in clinical practice: pros and cons?

Gianfranco Ferraccioli et al. Arthritis Res Ther. .

Abstract

The CERERRA database provides evidence that low-dose rituximab performs as well as the conventional dose in the real world, thus highlighting the possible pharmacoeconomic impact. In clinical trials, it has been shown that rituximab 500 mg twice, performs as well as 1 g twice, 2 weeks apart, in terms of the American College of Rheumatology (ACR)20 and ACR50, but not the ACR70. The choice should always be made after considering that the IMAGE trial has demonstrated similar radiographic progression after the first 6 months, but with less control, with low-dose rituximab in the first 6 months. A possible alternative can be hypothesized.

Keywords: High dose; Low dose; Peripheral B cell depletion; Rituximab; Synovial tissue B cell depletion.

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Figures

Fig. 1
Fig. 1
Rituximab in rheumatoid arthritis patients with moderate (a) or high (b) disease activity at baseline. A possible pragmatic approach following a treat-to-target strategy in the real world. The low-dose (LD) schedule for rituximab is likely appropriate in those with moderate disease activity at baseline, with the conventional dose (CD) in those with high disease activity at baseline. More data are needed on a flexible schedule to be used according to the effective B-cell depletion
See this image and copyright information in PMC

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