Rituximab for rheumatoid arthritis: A meta-analysis and systematic review

16Citations
Citations of this article
97Readers
Mendeley users who have this article in their library.

Abstract

Background: Rituximab (RTX) is a biological agent used for the treatment of refractory rheumatoid arthritis (RA). The present systematic review and meta-analysis update the safety and efficacy of RTX for the treatment of RA in data published since 2006. Methods: We searched PubMed from January 2000 to March 2010, and recent ACR Annual meeting abstracts for randomized (RCT) and non-randomized, controlled clinical trials (CCT) investigating the effects of RTX in RA. Included studies were at least six months, included participants who were ≥16 years of age meeting ACR revised criteria for RA, and compared RTX in combination with any DMARD or RTX alone versus placebo or other DMARDs or any biologic. Studies were excluded if they included patients previously exposed to RTX. Two reviewers independently extracted the data, and disagreement was resolved by discussion and consensus. The primary outcome was the Disease Activity Score (DAS28). The secondary outcome was American College of Rheumatology (ACR50) response. The efficacy results were combined in a meta-analysis. The primary endpoint was analyzed as a continuous variable using a random-effects analysis model to account for the fact that intervention effects were not uniform across all the studies. The secondary endpoint was analyzed as an odds ratio using the Mantel-Haenszel estimator under a random effects model to account for heterogenity in intervention effects across the studies. Descriptive statistics were used to compare adverse event (AE) rates and included both randomized and observational trials. Results: For the meta-analysis of efficacy, we initially examined 45 studies, devolving to 6 studies after applying inclusion/exclusion criteria. 5 were RCTs and 1 was a controlled clinical trial. Improvements in DAS28 and ACR50 statistically favored RTX (Figure 1). For the safety evaluation, 22 studies (5 RCTs and 17 observational studies) were examined. Infusion-related reactions were higher in the RTX group (mean: 28%) vs. placebo (18%). Overall infection incidence was similar for both groups (RTX: 39 vs. placebo: 40%). Conclusions: Our updated review supports RTX as a safe and efficacious therapy for treatment-naïve and methotrexate and/or TNFalpha refractory patients with RA. AE's revealed no more frequent infections than control. Future trials need to assess the longer-term efficacy and safety of RTX for RA, as well as the optimal time of re-administration of this agent. © the author(s), publisher and licensee Libertas Academica Ltd.

References Powered by Scopus

The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis

19361Citations
N/AReaders
Get full text

Assessing the quality of reports of randomized clinical trials: Is blinding necessary?

14735Citations
N/AReaders
Get full text

Modified disease activity scores that include twenty‐eight‐joint counts development and validation in a prospective longitudinal study of patients with rheumatoid arthritis

5515Citations
N/AReaders
Get full text

Cited by Powered by Scopus

2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty

123Citations
N/AReaders
Get full text

2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty

93Citations
N/AReaders
Get full text

2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty

76Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Volkmann, E. R., Agrawal, H., Maranian, P., & Furst, D. E. (2010). Rituximab for rheumatoid arthritis: A meta-analysis and systematic review. Clinical Medicine Insights: Therapeutics. Libertas Academica Ltd. https://doi.org/10.4137/cmt.s5566

Readers over time

‘12‘13‘14‘15‘16‘17‘18‘19‘20‘21‘22‘23‘24‘2505101520

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 35

73%

Researcher 7

15%

Professor / Associate Prof. 4

8%

Lecturer / Post doc 2

4%

Readers' Discipline

Tooltip

Medicine and Dentistry 47

81%

Agricultural and Biological Sciences 4

7%

Immunology and Microbiology 4

7%

Pharmacology, Toxicology and Pharmaceut... 3

5%

Save time finding and organizing research with Mendeley

Sign up for free
0