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

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作者
Gianfranco Ferraccioli
Barbara Tolusso
Elisa Gremese
机构
[1] Catholic University of the Sacred Heart,Institute of Rheumatology, School of Medicine
[2] Catholic University of the Sacred Heart,Institute of Rheumatology, Fondazione Policlinico Gemelli
关键词
Rituximab; Low dose; High dose; Synovial tissue B cell depletion; Peripheral B cell depletion;
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摘要
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.
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