Rituximab treatment of refractory rheumatoid arthritis.
OBJECTIVE
To review published literature using rituximab for treatment of refractory rheumatoid arthritis (RA).


METHODS
An English-language literature search was conducted using MEDLINE (1966-May 2005) and EMBASE (1980-May 2005). References of identified articles were subsequently reviewed for additional data.


RESULTS
Evidence suggests that B lymphocyte depletion in patients suffering from refractory RA may be a key component in the interruption of the disease pathogenesis. Successful depletion of B lymphocytes with rituximab in patients with RA has been reported in case reports, open-label pilot studies, and a randomized, double-blind, placebo-controlled trial.


CONCLUSIONS
Based on the limited published data, rituximab, when used in combination with other agents (ie, cyclophosphamide or methotrexate), appears to be a reasonable treatment option for refractory RA. However, additional controlled trials need to be conducted to further define optimal dosing, response rates, comparative long-term efficacy, and RA treatment algorithm placement of rituximab in this patient population.
Summers
Kelly M
KM
Adult Internal Medicine Pharmacy Resident, Virginia Commonwealth University Medical Center/Medical College of Virginia Hospitals, Richmond, 23298, USA.
Kockler
Denise R
DR
D000465:Algorithms; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D001402:B-Lymphocytes / Q000502:physiology; D002986:Clinical Trials as Topic; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab