Drug levels, anti-drug antibodies and B-cell counts were not predictive of response in rheumatoid arthritis patients on (ultra-)low-dose rituximab.
In: Rheumatology (Oxford, England), Jg. 61 (2022-10-06), Heft 10, S. 3974-3980
Online
academicJournal
Zugriff:
Objectives: The REDO trial (REtreatment with Rituximab in RhEumatoid arthritis: Disease Outcome after Dose Optimisation) showed that ultra-low-dose rituximab (500 mg or 200 mg) was similarly effective to a 1000 mg dosage in the majority of RA patients. This pre-planned secondary analysis investigated (1) associations between rituximab dosage, drug levels, anti-drug antibodies (ADAs) and B-cell counts and (2) the predictive value of pharmacokinetic and pharmacodynamic parameters, and of patient, disease and treatment characteristics in relation to response to ultra-low-dose rituximab.
Methods: For 140 RA patients from the REDO trial, differences in drug levels, ADAs and B-cell counts were examined at baseline, and at 3 and 6 months after dosing. Treatment response was defined as absence of flare and no extra rituximab or >1 glucocorticoid injection received during follow-up. The association between potential predictors and response was investigated using logistic regression analyses.
Results: Lower doses of rituximab resulted in lower drug levels but did not significantly affect ADA levels or B-cell counts, and 3 (10.7%), 12 (20.7%) and 7 (13.0%) patients failed to meet the response criteria in, respectively, the 1000 mg, 500 mg and 200 mg dosage groups. Drug levels, ADAs, B-cell counts, and patient, disease and treatment characteristics were not predictive for response to ultra-low-dose rituximab.
Conclusion: The results of this study further support the hypothesis that continued treatment with 500 or 200 mg rituximab is similarly effective to a 1000 mg dosage in RA patients doing well on rituximab. These results, combined with lack of finding a clinical dose-response relationship in the original REDO study, suggest that 200 mg rituximab is not yet the lowest effective rituximab retreatment dose in RA.
(© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Titel: |
Drug levels, anti-drug antibodies and B-cell counts were not predictive of response in rheumatoid arthritis patients on (ultra-)low-dose rituximab.
|
---|---|
Autor/in / Beteiligte Person: | Wientjes, MHM ; Gijzen, TMG ; den Broeder N ; Bloem, K ; de Vries A ; van den Bemt BJF ; den Broeder AA ; Verhoef, LM |
Link: | |
Zeitschrift: | Rheumatology (Oxford, England), Jg. 61 (2022-10-06), Heft 10, S. 3974-3980 |
Veröffentlichung: | Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999-, 2022 |
Medientyp: | academicJournal |
ISSN: | 1462-0332 (electronic) |
DOI: | 10.1093/rheumatology/keac024 |
Schlagwort: |
|
Sonstiges: |
|