In clinical studies, there is evidence that there are no significant clinical differences between administering rituximab 1000 mg or 2000 mg each cycle in rheumatoid arthritis (RA) patients, and low-dose cycles appear to have a better safety profile. For this study, researchers wanted to explain the pattern of rituximab usage in real-world practice settings. The Rituximab for RA in Clinical Practice (RITAR) research was conducted from 2005 to 2015. Adults with RA who were receiving rituximab for active articular disease met the eligibility criteria. The key outcome was response duration, which was measured in months from the date of the first rituximab infusion to the date of flare. To investigate the factors related to reaction time, a multivariable analysis was undertaken.
A total of 114 individuals and 409 cycles were documented, with 93.0% seropositive patients and 80.7% female patients. Rituximab was predominantly utilized as a second-line biological treatment. In 94.6% of instances, on-demand retreatment was employed, whereas fixed 6-month retreatment was used in 5.4%. The median response length to on-demand rituximab cycles was ten months (interquartile range, seven to thirteen). A multivariable analysis revealed that age over 65, the number of rituximab cycles, seropositivity, and first- or second-line treatment were all linked with a longer response duration. The dose given at each cycle had no effect on the length of the reaction.
Experience shows that a single infusion of 1000 mg rituximab on demand is a realistic plan for long-term treatment of patients who respond well after the first cycles, particularly in seropositive patients and when used as a first- or second-line biological therapy.