Department of Internal Medicine II (Oncology, Haematology, Immunology, Rheumatology, Pulmology), University Hospital Tuebingen, Otfried-Mueller-Str. 10, 72076, Tuebingen, Germany.
Rheumatol Int. 2010 Mar;30(5):709-12. doi: 10.1007/s00296-009-1302-z. Epub 2009 Dec 12.
Rituximab has only been approved in combination with methotrexate for the treatment of rheumatoid arthritis. As some patients have intolerance to methotrexate, alternative co-therapies are needed. This method involved retrospective analysis of ten patients treated with a combination of rituximab and leflunomide. Primary outcome measures were the DAS28 response at month 6 and the time to relapse. The median initial DAS 28 of 5.7 (3.2-7.2) was reduced to 3.5 (1.9-6.1) at month 6. 70% of the patients achieved a good or moderate response, whereas 30% showed no response. Two patients had to stop leflunomide due to adverse effects. Two patients had to reduce the leflunomide dose to 10 mg/day. 5/8 patients experienced a relapse after a median of 10 (6-30) months and were successfully re-treated with rituximab. This small case series suggests that leflunomide might offer an alternative DMARD combination option for the treatment of RA with rituximab.
利妥昔单抗仅被批准与甲氨蝶呤联合用于治疗类风湿关节炎。由于一些患者对甲氨蝶呤不耐受，因此需要替代的联合治疗方法。该方法涉及对 10 例接受利妥昔单抗和来氟米特联合治疗的患者进行回顾性分析。主要观察指标为治疗 6 个月时的 DAS28 缓解率和复发时间。初始 DAS28 的中位数为 5.7（3.2-7.2），治疗 6 个月后降至 3.5（1.9-6.1）。70%的患者获得了良好或中度缓解，而 30%的患者无缓解。由于不良反应，有 2 名患者停止使用来氟米特。有 2 名患者将来氟米特剂量减少至 10mg/天。5/8 例患者在中位数 10（6-30）个月后复发，并成功接受利妥昔单抗再治疗。这项小病例系列研究表明，来氟米特可能为使用利妥昔单抗治疗类风湿关节炎提供了另一种 DMARD 联合治疗选择。
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