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Evidence suggests rituximab monotherapy better than switching


New data presented at the European League Against Rheumatism (EULAR) annual meeting found that when rheumatoid arthritis (RA) patients do not respond to a TNF inhibitor, a commonly used class of drugs in RA, it is more effective to treat them with MabThera® (rituximab), than to use a second TNF inhibitor therapy.

This calls into question the practice of “cycling” between anti-TNFs, and provides evidence that supports preliminary NICE guidance where anti-TNF switching has not been recommended.

This data shows that MabThera, with a different mode of action to anti-TNFs, may benefit patients earlier in their treatment pathway.

The study was conducted among 300 patients who had previously not responded to TNF inhibitor therapy. Data at six months showed that MabThera achieved a significantly larger reduction in disease activity (DAS28) than a subsequent anti-TNF agent in patients who had ceased anti-TNF therapy due to lack of efficacy (reduction in DAS28 by 1.55 versus 1.03).

“These findings confirm that switching to an alternative biological agent, such as rituximab, in the subset of RA patients who don’t respond to a first anti-TNF agent, can provide major benefits”, said Professor Rob Moots, Aintree University Hospitals.

“In patients with persistent active disease despite anti-TNF therapy, these data suggest that switching to rituximab might be more effective than switching to an alternative anti-TNF agent.”


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