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Reumatol Clin. 2016 Nov - Dec;12(6):319-322. doi: 10.1016/j.reuma.2015.11.019. Epub 2016 Jan 29.

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.

[Article in English, Spanish]

Author information

1
Hospital General Hospitalet-Moisès Broggi, Sant Joan Despí, Barcelona, España. Electronic address: vtorrente@hsjdbcn.org.
2
Hospital Santa Creu i Sant Pau, Barcelona, España.
3
Hospital del Vendrell, El Vendrell, Tarragona, España.
4
Hospital de Viladecans, Viladecans, Barcelona, España.
5
Hospital de Palamós, Palamós, Girona, España.
6
Hospital General Hospitalet-Moisès Broggi, Sant Joan Despí, Barcelona, España.
7
Hospital de San Jorge, Huesca, España.
8
Hospital de la Vall d'Hebron, Barcelona, España.
9
Hospital de Mollet, Mollet del Vallès, Barcelona, España.
10
Hospital de Torrevieja, Torrevieja, Alicante, España.

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.

KEYWORDS:

Anti-TNF-alfa; Anti-TNF-alpha; Artritis reumatoide; Rheumatoid arthritis; Rituximab

PMID:
26831256
DOI:
10.1016/j.reuma.2015.11.019
[Indexed for MEDLINE]
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