Longterm safety of patients receiving rituximab in rheumatoid arthritis clinical trials.
OBJECTIVE
To evaluate the longterm safety of rituximab in clinical trials in patients with rheumatoid arthritis (RA).


METHODS
Pooled analysis of safety data, including adverse events (AE) and infections, from patients treated with rituximab in combination with methotrexate in a global clinical trial program.


RESULTS
A total of 2578 patients with RA received at least 1 course of rituximab. Safety analyses were based on 5013 patient-years of rituximab exposure. The most frequent AE was infusion-related reactions (25% of patients during the first infusion of Course 1). Less than 1% of infusion-related reactions were considered serious. Rates of AE and serious AE (SAE; 17.85 events/100 patient-yrs, 95% CI 16.72, 19.06) were stable following each course. The overall serious infection rate was 4.31/100 patient-years (95% CI 3.77, 4.92). Infections and serious infections over time remained stable across 5 courses at 4-6 events/100 patient-years. Compared with other patients with RA and with the general US population, there was no increased risk of malignancy.


CONCLUSIONS
In this longterm safety update in RA clinical trial patients, rituximab remained well tolerated over multiple courses. SAE and infections remained stable over time and by treatment course.
van Vollenhoven
Ronald F
RF
Karolinska University Hospital, Stockholm, Sweden. ronald.van.vollenhoven@ki.se
Emery
Paul
P
Bingham
Clifton O
CO
Keystone
Edward C
EC
Fleischmann
Roy
R
Furst
Daniel E
DE
Macey
Katherine
K
Sweetser
Marianne
M
Kelman
Ariella
A
Rao
Ravi
R
D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology; D002986:Clinical Trials as Topic; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology; D012307:Risk Factors; D000069283:Rituximab; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D007136:Immunoglobulins; D000069283:Rituximab