Sustained Remission After Combination Therapy with Rituximab and Etanercept in Two Patients with Rheumatoid Arthritis After TNF Failure: Case Report.

Abstract

OBJECTIVES:

Approximately up to 40% of patients with rheumatoid arthritis (RA) fail to respond to tumor necrosis factor (TNF) inhibitors, lose response over time or are unable to tolerate treatment.

MATERIALS AND METHODOLOGY:

We report two female patients suffering from active, refractory rheumatoid arthritis despite TNF blocking agents who have been treated with rituximab added to ongoing therapy with etanercept.

RESULTS:

Combination therapy was tolerated without any acute side effects. Both patients improved with a significant, long lasting reduction of disease activity (DAS28, CRP). Evaluation of the immunological parameters showed the expected B-cell depletion and a transient reduction of immunoglobulin-levels. One patient developed four serious infections requiring antibiotic treatment (1 pneumonia, 3 exacerbations of her pre-existing chronic bronchitis) within follow up of 45 months.

CONCLUSION:

Combination therapy of rituximab and etanercept lead to a significant improvement of clinical disease activity and inflammatory parameters in two RA patients refractory to anti-TNF treatment.

• Authors: Martin Feuchtenberger, Christian Kneitz, Petra Roll, Stefan Kleinert, Hans-Peter Tony
• Journal: The open rheumatology journal (Open Rheumatol J) Vol. 3 Pg. 9-13 (Feb 09 2009) ISSN: 1874-3129 [Electronic] United Arab Emirates
• PMID: 19479056 (Publication Type: Journal Article)