Key clinical point: Reduced doses of rituximab can be considered in patients with rheumatoid arthritis (RA) who have had treatment failure with multiple biologic disease-modifying antirheumatic drugs (bDMARD), significant comorbidities, and an initial sustained clinical response.
Major finding: Over a 60-month follow-up, only 7.5% and 5.9% of patients relapsed on low-dose and standard-dose rituximab, respectively ( P = .6), with patients on low-dose vs. standard-dose rituximab having significantly lower rates of serious adverse events (incidence rate: 0.77 vs. 1.57 per 1000 person-years; P < .0001) and drug discontinuation due to treatment failure (37.9% vs. 63.6%; P < .0001).
Study details: This was a prospective, observational study including 361 patients with established RA and prior failure using bDMARD who received low-dose (n = 81) or standard-dose (n =280) rituximab.
Disclosures: The study was partly supported by the Pancretan Health Association. The authors declared no conflicts of interest.
Source: Bertsias A et al. Rheumatoid arthritis patients initiating rituximab with low number of previous bDMARDs failures may effectively reduce rituximab dose and experience fewer serious adverse events than patients on full dose: A 5-year cohort study. Arthritis Res Ther. 2022;24:132 (Jun 2). Doi: 10.1186/s13075-022-02826-6