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Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis
Rheumatology, 09/30/09

Quartuccio L et al. – RF-positive rather than anti-CCP-positive RA patients with lower baseline disability and a lower number of previously failed TNF blockers may be the best candidates to RTX.

Methods

RTX was used in 110 RA patients
The mean disease activity score on 28 joints (DAS28) was 6.4 ± 0.99 and the mean HAQ was 1.63 ± 0.68 at baseline
Thirty-two patients (29.1%) underwent RTX after the failure of DMARD therapy, 37 (33.6%) had failed or were intolerant to at least two anti-TNF agents, and 41 (37.3%) had failed or were intolerant to one anti-TNF agent

Results

The number of previous anti-TNF agents, HAQ, RF positivity, and anti-cyclic citrullinated peptide (anti-CCP) positivity were associated with ACR response 50 between month +4 and month +6 after starting RTX by univariate analysis
Multivariate analysis confirmed that a lower HAQ, a lower number of anti-TNF agents failed before RTX and RF positivity, but not anti-CCP positivity, were the selected variables associated with an ACR response 50, with an accuracy of 84% of the model
Only RF positivity correlated with EULAR moderate to good response both in the univariate and in the multivariate analysis, with an accuracy of 79% of the model

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