Document Detail

Clinical response, pharmacokinetics, development of human anti-chimaeric antibodies, and synovial tissue response to rituximab treatment in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  19596693     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To analyse whether persistence of synovial B lineage cells and lack of clinical response to rituximab treatment in patients with rheumatoid arthritis (RA) are associated with low rituximab serum levels and anti-rituximab antibody (ARA) formation. METHODS: Fifty-eight patients with RA were treated with rituximab. The clinical response was determined 24 weeks after each treatment course using the Disease Activity Score evaluated in 28 joints (DAS28) and EULAR response criteria. Rituximab serum levels, ARAs and synovial B lineage cell numbers were determined before and after treatment. RESULTS: Four weeks after treatment rituximab serum levels were highly variable. Low rituximab levels were associated with ARA formation (in five patients (8.6%)) and high baseline erythrocyte sedimentation rate. Interestingly, serum rituximab levels were not related to persistence of synovial B lineage cells or clinical response. Furthermore, response to treatment and re-treatment was similar in ARA-positive and ARA-negative patients. CONCLUSION: There is clear variability in serum levels after rituximab treatment, but rituximab levels are not lower in patients with persistence of synovial B lineage cells or lack of clinical response. The current treatment schedule suffices to induce and maintain a clinical response, even when ARAs are formed.
R M Thurlings; O Teng; K Vos; D M Gerlag; L Aarden; S O Stapel; J M van Laar; P P Tak; G J Wolbink
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-07-12
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  69     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-28     Completed Date:  2010-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  409-12     Citation Subset:  IM    
Academic Medical Centre/University of Amsterdam, The Netherlands.
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MeSH Terms
Antibodies, Anti-Idiotypic / blood*
Antibodies, Monoclonal / blood,  immunology,  therapeutic use*
Arthritis, Rheumatoid / blood,  drug therapy*,  immunology
B-Lymphocyte Subsets / drug effects,  immunology
Cohort Studies
Severity of Illness Index
Synovial Membrane / immunology*
Treatment Outcome
Reg. No./Substance:
0/Antibodies, Anti-Idiotypic; 0/Antibodies, Monoclonal; 0/rituximab

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