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Published Online, 25 October 2005, www.theannals.com, DOI 10.1345/aph.1G311.
 The Annals of Pharmacotherapy: Vol. 39, No. 12, pp. 2091-2095. DOI 10.1345/aph.1G311
© 2005 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Rituximab Treatment of Refractory Rheumatoid Arthritis

Kelly M Summers, PharmD1, and Denise R Kockler, PharmD2

1 at time of writing, Adult Internal Medicine Pharmacy Resident, Virginia Commonwealth University Medical Center/Medical College of Virginia Hospitals, Richmond, VA; now, Assistant Professor of Pharmacotherapy/Cardiology, Department of Pharmacy Practice & Science, School of Pharmacy, University of Maryland, Baltimore, MD
2 Director, Drug Information Services, Virginia Commonwealth University Medical Center, Medical College of Virginia Hospitals

Reprints: Dr. Kockler, Virginia Commonwealth University, Medical College of Virginia Hospitals, 401 N. 12th St., PO Box 980042, Richmond, VA 23298-0042, fax 804/628-3919, 9dkockle{at}vcu.edu

OBJECTIVE: To review published literature using rituximab for treatment of refractory rheumatoid arthritis (RA).

DATA SOURCES: An English-language literature search was conducted using MEDLINE (1966-May 2005) and EMBASE (1980-May 2005). References of identified articles were subsequently reviewed for additional data.

DATA SYNTHESIS: Evidence suggests that B lymphocyte depletion in patients suffering from refractory RA may be a key component in the interruption of the disease pathogenesis. Successful depletion of B lymphocytes with rituximab in patients with RA has been reported in case reports, open-label pilot studies, and a randomized, double-blind, placebo-controlled trial.

CONCLUSIONS: Based on the limited published data, rituximab, when used in combination with other agents (ie, cyclophosphamide or methotrexate), appears to be a reasonable treatment option for refractory RA. However, additional controlled trials need to be conducted to further define optimal dosing, response rates, comparative long-term efficacy, and RA treatment algorithm placement of rituximab in this patient population.

Key Words: rheumatoid arthritis, rituximab

Published Online, October 25, 2005. www.theannals.com, DOI 10.1345/aph.1G311


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