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001-es BibID:BIBFORM007055
Első szerző:Brodszky Valentin
Cím:A rituximab szerepe a rheumatoid arthritis kezelésében : irodalmi áttekintés / Brodszky, V., Czirjak, L., Geher, P., Hodinka, L., Karpati, K., Pentek, M., Poor, G., Szekanecz, Z., Gulacsi, L.
Dátum:2007
ISSN:0030-6002 (Print)
Megjegyzések:Biologic treatments are newly used in rheumatoid arthritis. Three tumornecrosis factor alfa (TNF-alpha) inhibitors--adalimumab, etanercept and infliximab--have been licensed for rheumatoid arthritis in Hungary. B-cell targeted treatment with rituximab is the next biologic treatment. Rituximab was used earlier for the treatment of non-Hodgkin's lymphoma. Rituximab was registered to be used in patients with rheumatoid arthritis who have had an inadequate response or an intolerance to one or more TNF-alpha blocking agents. AIM: Systematic review in the literature of efficacy of rituximab in rheumatoid arthritis. To assess the efficacy and safety of rituximab treatment in patients with rheumatoid arthritis. METHODS: MEDLINE and Cochrane database were searched for randomized controlled trials with rituximab in rheumatoid arthritis. A meta-analysis of trial data was conducted. RESULTS: Three randomized controlled trials were identified including 1145 patients. 54% of patients with inadequate response to TNF-alfa inhibitors and severe disease-activity have reached American College of Rheumatology 20 criteria. This ratio is larger with 33% (95% CI, 25-41%) than without treatment, and patients have almost five times (relative risk = 4.77 95% CI, 3.12-7.31) chance to improve. Functional status represented by Health Assessment Questionnaire score improves significantly (p < 0.001) in rituximab arms (-0.4 scores) compared with placebo arms (-0.1 scores). EULAR moderate and good responses in the rituximab group were significant (p < 0.00001) compared with the placebo group, rate difference is 38% (95% CI, 32-44%). Rituximab improves also radiological symptoms of rheumatoid arthritis. CONCLUSIONS: New therapeutic options, rituximab is efficacious in patients with rheumatoid arthritis. Rituximab can improve symptoms of patients with inadequate response to or intolerance of TNF-alpha inhibitors.
Tárgyszavak:Orvostudományok Klinikai orvostudományok magyar nyelvű folyóiratközlemény hazai lapban
Antibodies, Monoclonal
Antirheumatic Agents
Arthritis, Rheumatoid
Drug Approval
Health Status
Humans
Hungary
Immunoglobulin G
Questionnaires
Receptors, Tumor Necrosis Factor
Treatment Outcome
Tumor Necrosis Factor-alpha
Megjelenés:Orvosi Hetilap. - 148 : 40 (2007), p. 1883-1893. -
További szerzők:Czirják László Géher Pál Hodinka László Kárpáti Krisztián Péntek Márta Poór Gyula Szekanecz Zoltán (1964-) (reumatológus, belgyógyász, immunológus) Gulácsi László
Internet cím:elektronikus változat
elektronikus változat
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