title: Longterm followup of rituximab therapy in patients with rheumatoid arthritis: results from the Belgian MabThera in Rheumatoid Arthritis registry.
abstract: OBJECTIVE
  Our study reports the results of the MIRA (MabThera In Rheumatoid Arthritis) registry, set up to collect data about clinical usage, patient profile, and retention of rituximab (RTX) treatment in daily clinical practice in Belgium.
  
  
  METHODS
  Patients with active rheumatoid arthritis (RA) who failed at least 1 anti-tumor necrosis factor (anti-TNF) treatment were included in our study between November 2006 and October 2011. At baseline, demographics, medication, disease history, disease activity, rheumatoid factor (RF), and anticyclic citrullinated peptide antibodies (anti-CCP) status were recorded. Evolution of the 28-joint Disease Activity Score (DAS28)-erythrocyte sedimentation rate, retreatments, and reasons for therapy stop were followed prospectively.
  
  
  RESULTS
  The MIRA registry included 649 patients, with mean disease duration of 12.8 ± 0.4 years and DAS28 values at inclusion of 5.85 ± 0.48. Patients received on average 2.82 ± 0.07 (range 1-9) RTX treatments, over a mean followup period of 93.1 ± 2.6 weeks. At database lock, 433 patients (66.7%) were still under RTX treatment, 182 (28.0%) had stopped treatment, and 34 (5.2%) were lost to followup. Ineffectiveness (n = 108, 59%) and safety concerns (n = 39, 22%) were the most frequent reasons for discontinuing RTX therapy. From 2006 to 2011, RTX practice patterns clearly evolved toward RTX being started in patients with a lower number of previously failed anti-TNF drugs and lower baseline DAS28 values. A lower number of previous anti-TNF drugs, and positivity for RF and anti-CCP, predicted more successful longterm treatment. RTX treatment provided adequate longterm disease control.
  
  
  CONCLUSIONS
  In our daily practice study, RTX provided good longterm disease control and treatment retention in refractory patients with RA. Over the years, rheumatologists tended to start this treatment in patients with fewer previous anti-TNF treatments and lower disease activity.
authors.affiliation: From the Department of Rheumatology, Ghent University Hospital, Ghent; GZA St-Augustinus Hospital, Antwerp; Department of Rheumatology, University Hospital Liège, Liège; Pôle de Recherche en Rhumatologie; Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels; Skeletal Biology and Engineering Research Center; the Department of Development and Regeneration; KU Leuven, Leuven, Belgium.F. De Keyser, MD, PhD, Department of Rheumatology, Ghent University Hospital; I. Hoffman, MD, PhD, GZA St-Augustinus Hospital; P. Durez, MD, PhD, Pôle de Recherche en Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc; M.J. Kaiser, MD, PhD, Department of Rheumatology, University Hospital Liège; R. Westhovens, MD, PhD, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Rheumatology. filip.dekeyser@ugent.be.
authors.forename: Filip
authors.initials: F
authors.lastname: De Keyser
authors.affiliation: From the Department of Rheumatology, Ghent University Hospital, Ghent; GZA St-Augustinus Hospital, Antwerp; Department of Rheumatology, University Hospital Liège, Liège; Pôle de Recherche en Rhumatologie; Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels; Skeletal Biology and Engineering Research Center; the Department of Development and Regeneration; KU Leuven, Leuven, Belgium.F. De Keyser, MD, PhD, Department of Rheumatology, Ghent University Hospital; I. Hoffman, MD, PhD, GZA St-Augustinus Hospital; P. Durez, MD, PhD, Pôle de Recherche en Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc; M.J. Kaiser, MD, PhD, Department of Rheumatology, University Hospital Liège; R. Westhovens, MD, PhD, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Rheumatology.
authors.forename: Ilse
authors.initials: I
authors.lastname: Hoffman
authors.affiliation: From the Department of Rheumatology, Ghent University Hospital, Ghent; GZA St-Augustinus Hospital, Antwerp; Department of Rheumatology, University Hospital Liège, Liège; Pôle de Recherche en Rhumatologie; Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels; Skeletal Biology and Engineering Research Center; the Department of Development and Regeneration; KU Leuven, Leuven, Belgium.F. De Keyser, MD, PhD, Department of Rheumatology, Ghent University Hospital; I. Hoffman, MD, PhD, GZA St-Augustinus Hospital; P. Durez, MD, PhD, Pôle de Recherche en Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc; M.J. Kaiser, MD, PhD, Department of Rheumatology, University Hospital Liège; R. Westhovens, MD, PhD, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Rheumatology.
authors.forename: Patrick
authors.initials: P
authors.lastname: Durez
authors.affiliation: From the Department of Rheumatology, Ghent University Hospital, Ghent; GZA St-Augustinus Hospital, Antwerp; Department of Rheumatology, University Hospital Liège, Liège; Pôle de Recherche en Rhumatologie; Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels; Skeletal Biology and Engineering Research Center; the Department of Development and Regeneration; KU Leuven, Leuven, Belgium.F. De Keyser, MD, PhD, Department of Rheumatology, Ghent University Hospital; I. Hoffman, MD, PhD, GZA St-Augustinus Hospital; P. Durez, MD, PhD, Pôle de Recherche en Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc; M.J. Kaiser, MD, PhD, Department of Rheumatology, University Hospital Liège; R. Westhovens, MD, PhD, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Rheumatology.
authors.forename: Marie-Joëlle
authors.initials: MJ
authors.lastname: Kaiser
authors.affiliation: From the Department of Rheumatology, Ghent University Hospital, Ghent; GZA St-Augustinus Hospital, Antwerp; Department of Rheumatology, University Hospital Liège, Liège; Pôle de Recherche en Rhumatologie; Institut de Recherche Expérimentale et Clinique; Université Catholique de Louvain and Cliniques Universitaires Saint-Luc, Brussels; Skeletal Biology and Engineering Research Center; the Department of Development and Regeneration; KU Leuven, Leuven, Belgium.F. De Keyser, MD, PhD, Department of Rheumatology, Ghent University Hospital; I. Hoffman, MD, PhD, GZA St-Augustinus Hospital; P. Durez, MD, PhD, Pôle de Recherche en Rhumatologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc; M.J. Kaiser, MD, PhD, Department of Rheumatology, University Hospital Liège; R. Westhovens, MD, PhD, Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Rheumatology.
authors.forename: Rene
authors.initials: R
authors.lastname: Westhovens
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D019233:Retreatment; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab
keywords: ANTIRHEUMATIC AGENTS; COHORT STUDY; DAS28; RHEUMATOID ARTHRITIS; RITUXIMAB