Evaluation of the clinical and anti-destructive effect of an anti-B cell preparation depending on concomitant therapy with basic anti-inflammatory drugs and glucocorticoids in patients with rheumatoid arthritis

Abstract

Aim: To evaluate the effectiveness, safety and anti-destructive effect of anti-B-cell therapy (rituximab) in various combinations (RTM-mono, RTM + DMARD, RTM + GK) in patients with rheumatoid arthritis in real clinical practice.Materials and methods: Clinical and radiological evaluation of 110 patients with rheumatoid arthritis who received rituximab therapy (RTM) as monotherapy (group 1), in combination with methotrexate (group 2), leflunomide (group 3), and group 4 with other basic anti-inflammatory drugs.Results: When assessing at 48 weeks of treatment with these regimens, the achievement of remission and a low degree of activity was observed in 22.36% of patients. An X-ray evaluation showed the absence of progression in the total score in 60.9%. When assessing progression in the monotherapy group, there was no progression in 76.92%, in the group of PTM + MT – in 54.29%, in the group of PTM + LEF – 65.0%, in the group of other DMARDs – 50% of patients. When assessing the clinical effect in the group receiving GK – remission and a low degree of activity – 19.67% of patients, in the group without GK – 21.05%. Assessing the radiological dynamics, it was shown that in the group not receiving GK – inhibition by the total score occurred in 54.55%, receiving – 61.54%.Conclusion: This work has demonstrated the high therapeutic efficacy of RTM in real clinical practice. There were no significant differences in the degree of progression depending on the concomitant therapy of DMARDs or GK. In the treatment of RTM, inhibition of articular destruction is possible even against the background of clinical deterioration.

Keywords

• rheumatoid arthritis
• rituximab
• dmards
• glucocorticoids
• clinical effect
• bone destruction