Rituximab treatment for spondyloarthritis. A nationwide series: data from the AIR registry of the French Society of Rheumatology.
OBJECTIVE
To evaluate the efficacy and safety of rituximab (RTX) in several subsets of spondyloarthritis (SpA) using the data of the AIR (Autoimmunity and Rituximab) registry.


METHODS
All patients receiving RTX for SpA, and prospectively included in the AIR registry from September 2005 to September 2010, were retrospectively analyzed. The response to treatment was evaluated by the Bath Ankylosing Spondylitis Disease Activity Index for axial disease, joint count for peripheral disease, and C-reactive protein reduction.


RESULTS
Among the 595 patients included in the AIR registry, 26 patients with SpA from 13 centers were reported: ankylosing spondylitis (10), undifferentiated SpA (7), and psoriatic arthritis (9). Mean disease duration was 8.8 years (range 1-40). The extraarticular features found were psoriasis, 12 cases; uveitis, 4 cases; and Crohn's disease, 3 cases. The mean number of disease-modifying antirheumatic drugs before RTX was 2.4; previous anti-tumor necrosis factor (TNF) agents were taken in 23 cases. The mean number of RTX courses was 1.5 (range 1-5), with a total of 35.6 patient-years. Efficacy was noted in 11/23 cases: 3 out of 3 anti-TNF-naive patients and 8 out of 20 anti-TNF nonresponder patients. No predictive factors of response could be identified, particularly in diagnosis subsets or clinical presentation (axial or peripheral).


CONCLUSIONS
In this nationwide study of several subsets of SpA, RTX had only a moderate efficacy that was more marked in patients who were anti-TNF-naive.
Department of Rheumatology, CHU de Besançon, and EA 4266, Université de Franche-Comté, Besançon; Paris-Descartes University, Paris, France. dwendling@chu-besancon.fr
Daniel
D
Wendling
Maxime
M
Dougados
Francis
F
Berenbaum
Olivier
O
Brocq
Thierry
T
Schaeverbeke
Bernard
B
Mazieres
Christian
C
Marcelli
Jean-Marie
JM
Leparc
Philippe
P
Bertin
Michèle
M
Robin
Jean
J
Sibilia
Pierre
P
Lafforgue
Clément
C
Prati
Bernard
B
Combe
Jacques-Eric
JE
Gottenberg
D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D057915:Drug Substitution; D005260:Female; D005602:France; D006304:Health Status; D006801:Humans; D007596:Joints / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D000069283:Rituximab; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab; D002097:C-Reactive Protein