Rheumatology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia.
Department of Internal Medicine, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Med Sci Monit. 2024 Dec 1;30:e946178. doi: 10.12659/MSM.946178.
BACKGROUND Rituximab (RTX) is a chimeric therapeutic monoclonal antibody that targets the CD20 molecule on B lymphocytes. RTX is approved for the treatment of rheumatoid arthritis (RA) in patients who do not respond to disease-modifying anti-rheumatic drugs (DMARDs) or other biologics. The purpose of this retrospective study was to report our experience with RTX treatment at a single center in Saudi Arabia between 2015 and 2022 in 52 patients with RA. MATERIAL AND METHODS This retrospective cohort study at King Khalid University Hospital in Riyadh examined 52 patients with RA who received RTX from April 2015 to October 2022. Data were collected from electronic health records, including patient demographics, disease activity, and treatment details. The primary outcome was prednisolone tapering, with secondary outcomes including adverse reactions and disease activity. Statistical analysis was conducted using SPSS. RESULTS Out of 678 screened patients, 52 (7.7%) were recruited. Of these, 44 (84.6%) were female, with a mean disease duration of 28±7 years and a mean age of 57.1±11 years. Prednisolone was used by 22 patients (42.31%) at RTX initiation, with a mean dose of 10.45±10.25 mg. After RTX, the dose significantly dropped to 3.41±5.54 mg (P<0.001). Older patients, those from outside Riyadh, and those with fewer prior DMARDs were more likely to taper off without full dose reinstatement. CONCLUSIONS This retrospective study supports the findings from other studies and current clinical guidelines that recommend rituximab in patients with rheumatoid arthritis, highlighting the importance of patient monitoring during treatment. Multicenter studies are required to determine the economic impact of tapering biological drugs.
利妥昔单抗（RTX）是一种嵌合型治疗性单克隆抗体，靶向 B 淋巴细胞上的 CD20 分子。RTX 获批用于治疗对疾病修饰抗风湿药物（DMARDs）或其他生物制剂无应答的类风湿关节炎（RA）患者。本回顾性研究的目的是报告我们在沙特阿拉伯利雅得的一家单中心在 2015 年至 2022 年间使用 RTX 治疗 52 例 RA 患者的经验。
这项在利雅得国王哈利德国王大学医院进行的回顾性队列研究纳入了 2015 年 4 月至 2022 年 10 月期间接受 RTX 治疗的 52 例 RA 患者。数据来自电子病历，包括患者人口统计学、疾病活动度和治疗细节。主要结局是泼尼松减量，次要结局包括不良反应和疾病活动度。使用 SPSS 进行统计分析。
在 678 例筛查患者中，有 52 例（7.7%）被纳入。其中，44 例（84.6%）为女性，平均病程 28±7 年，平均年龄 57.1±11 岁。在开始使用 RTX 时，有 22 例（42.31%）患者使用泼尼松，平均剂量为 10.45±10.25mg。使用 RTX 后，剂量显著下降至 3.41±5.54mg（P<0.001）。年龄较大、来自利雅得以外地区以及先前使用较少 DMARDs 的患者更有可能在不减量的情况下停药。
这项回顾性研究支持了其他研究和当前临床指南的发现，即建议在类风湿关节炎患者中使用利妥昔单抗，强调了在治疗过程中监测患者的重要性。需要进行多中心研究来确定减少生物药物剂量的经济影响。
