TY - JOUR T1 - Rituximab Retreatment in Rheumatoid Arthritis in a Real-life Cohort: Data from the CERERRA Collaboration JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.160460 SP - jrheum.160460 AU - Katerina Chatzidionysiou AU - Elisabeth Lie AU - Galina Lukina AU - Merete L. Hetland AU - Ellen-Margrethe Hauge AU - Karel Pavelka AU - Cem Gabay AU - Almut Scherer AU - Dan Nordström AU - Helena Canhao AU - Maria José Santos AU - Matija Tomsic AU - Ziga Rotar AU - M. Victoria Hernández AU - Juan Gomez-Reino AU - Ioan Ancuta AU - Tore K. Kvien AU - Ronald van Vollenhoven Y1 - 2017/01/15 UR - http://www.jrheum.org/content/early/2017/01/05/jrheum.160460.abstract N2 - Objective Several aspects of rituximab (RTX) retreatment in rheumatoid arthritis (RA) need to be further elucidated. The aim of this study was to describe the effect of repeated courses of RTX on disease activity and to compare 2 retreatment strategies, fixed-interval versus on-flare retreatment, in a large international, observational, collaborative study. Methods In the first analysis, patients with RA who received at least 4 cycles with RTX were included. In the second analysis, patients who received at least 1 RTX retreatment and for whom information about the strategy for retreatment was available were identified. Two retreatment strategies (fixed-interval vs on-flare) were compared by fitting-adjusted, mixed-effects models of 28-joint Disease Activity Score (DAS28) over time for first and second retreatment. Results A total of 1530 patients met the eligibility criteria for the first analysis. Significant reductions of mean DAS28 between the starts of subsequent treatment cycles were observed (at start of first treatment cycle: 5.5; second: 4.3; third: 3.8; and fourth: 3.5), suggesting improved response after each additional cycle (p < 0.0001 for all pairwise comparisons). A total of 800 patients qualified for the second analysis: 616 were retreated on flare and 184 at fixed interval. For the first retreatment, the fixed-interval retreatment group yielded significantly better results than the on-flare group (estimated marginal mean DAS28 = 3.8, 95% CI 3.6–4.1 vs 4.6, 95% CI 4.5–4.7, p < 0.0001). Similar results were found for the second retreatment. Conclusion Repeated treatment with RTX leads to further clinical improvement after the first course of RTX. A fixed-interval retreatment strategy seems to be more effective than on-flare retreatment. ER -