Maya H Buch 1 , 2 , Josef S Smolen 3 , 4 , Neil Betteridge 5 , Ferdinand C Breedveld 6 , Gerd Burmester 7 , Thomas Dörner 7 , Gianfranco Ferraccioli 8 , Jacques-Eric Gottenberg 9 , John Isaacs 10 , Tore K Kvien 11 , Xavier Mariette 12 , Emilio Martin-Mola 13 , Karel Pavelka 14 , Paul P Tak 15 , Desiree van der Heijde 6 , Ronald F van Vollenhoven 16 , Paul Emery 1 , 2 , for the Rituximab Consensus Expert Committee
6 March 2011
Since initial approval for the treatment of rheumatoid arthritis (RA), rituximab has been evaluated in clinical trials involving various populations with RA. Information has also been gathered from registries. This report therefore updates the 2007 consensus document on the use of rituximab in the treatment of RA.
Preparation of this new document involved many international experts experienced in the treatment of RA. Following a meeting to agree upon the core agenda, a systematic literature review was undertaken to identify all relevant data. Data were then interrogated by a drafting committee, with subsequent review and discussion by a wider expert committee leading to the formulation of an updated consensus statement. These committees also included patients with RA.
The new statement covers wide-ranging issues including the use of rituximab in earlier RA and impact on structural progression, and aspects particularly pertinent to rituximab such as co-medication, optimal dosage regimens, repeat treatment cycles and how to manage non-response. Biological therapy following rituximab usage is also addressed, and safety concerns including appropriate screening for hepatitis, immunoglobulin levels and infection risk. This consensus statement will support clinicians and inform patients when using B-cell depletion in the management of RA, providing up-to-date information and highlighting areas for further research.
New therapeutic strategies and treatment options for RA, a chronic destructive and disabling disease, have expanded over recent years. These have been summarised in general strategic suggestions and specific management recommendations, emphasising the importance of expedient disease-modifying antirheumatic drug implementation and tight disease control. This consensus statement is in line with these fundamental principles of management.