title: VARIAR Study: Assessment of short-term efficacy and safety of rituximab compared to an tumor necrosis factor alpha antagonists as second-line drug therapy in patients with rheumatoid arthritis refractory to a first tumor necrosis factor alpha antagonist.
abstract: OBJECTIVE
  to compare the short-term efficacy and safety of rituximab (RTX) therapy versus anti-TNF in rheumatoid arthritis (RA) patients after discontinuation of a first anti-TNF agent.
  
  
  METHODS
  prospective observational multicenter study in the clinical practice setting, involving patients with severe RA refractory to a first anti-TNF agent, who received either RTX or a second anti-TNF (2TNF), comparing the efficacy endpoints, EULAR response (Good/Moderate) and safety at 6 months.
  
  
  RESULTS
  103 patients enrolled, 82 completed 6-month follow-up, 73.7% women. Baseline data for RTX and 2TNF groups, respectively: TJC, 8.6 and 6.6; SJC, 8.8 and 7.5; DAS28 score, 5.45 (±1.28) and 5.18 (±1.21) (p=0.048), ESR, 41 and 38.7mmHg; and HAQ, 1.2 and 1.0. Improvement was observed in all parameters, with no significant differences (except for a more marked reduction in ESR with RTX). There were no serious adverse events.
  
  
  CONCLUSIONS
  RTX use as second-line therapy after anti-TNF failure led to improvements in the efficacy and functional variables at 6 months, with no serious adverse events. These results were comparable to those observed in patients who used a second anti-TNF agent in the same clinical scenario.
authors.affiliation: Hospital General Hospitalet-Moisès Broggi, Sant Joan Despí, Barcelona, España. Electronic address: vtorrente@hsjdbcn.org.
authors.forename: Vicenç
authors.initials: V
authors.lastname: Torrente-Segarra
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Asunción
authors.initials: A
authors.lastname: Acosta Pereira
authors.affiliation: Hospital del Vendrell, El Vendrell, Tarragona, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Morla
authors.affiliation: Hospital de Viladecans, Viladecans, Barcelona, España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Ruiz
authors.affiliation: Hospital de Palamós, Palamós, Girona, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Clavaguera
authors.affiliation: Hospital General Hospitalet-Moisès Broggi, Sant Joan Despí, Barcelona, España.
authors.forename: Ramon
authors.initials: R
authors.lastname: Figuls
authors.affiliation: Hospital General Hospitalet-Moisès Broggi, Sant Joan Despí, Barcelona, España.
authors.forename: Hector
authors.initials: H
authors.lastname: Corominas
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Carme
authors.initials: C
authors.lastname: Geli
authors.affiliation: Hospital de San Jorge, Huesca, España.
authors.forename: Rosa
authors.initials: R
authors.lastname: Roselló
authors.affiliation: Hospital de la Vall d'Hebron, Barcelona, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: de Agustín
authors.affiliation: Hospital de la Vall d'Hebron, Barcelona, España.
authors.forename: Cayetano
authors.initials: C
authors.lastname: Alegre
authors.affiliation: Hospital de Mollet, Mollet del Vallès, Barcelona, España.
authors.forename: Carolina
authors.initials: C
authors.lastname: Pérez
authors.affiliation: Hospital de Torrevieja, Torrevieja, Alicante, España.
authors.forename: Angel
authors.initials: A
authors.lastname: García
authors.affiliation: Hospital Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Arturo
authors.initials: A
authors.lastname: Rodríguez de la Serna
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069285:Infliximab / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069283:Rituximab / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D000069283:Rituximab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept
keywords: Anti-TNF-alfa; Anti-TNF-alpha; Artritis reumatoide; Rheumatoid arthritis; Rituximab