Treatment options in refractory rheumatoid arthritis

Objective: to evaluate rituximab efficacy in refractory rheumatoid arthritis treatment. Method: patients with active rheumatoidarthritis, who failed to achieve remission during DMARDs and biological (TNF inhibitors) therapies and received rituximab (1gintravenously on days 0 and 14 initially, the same scheme at 6 and 12 month) were assessed at baseline (T0), after 2 weeks(T1), 24 weeks (T2) and 48 weeks (T3) by: sera parameters (ESR values, CRP level, RF titer, anti-CCP antibody titers), diseaseactivity (DAS 28 score) and ability to perform activities of daily living (HAQ-DI score). Results: twelve patients with highly activerheumatoid arthritis (10 females and 2 males, mean age 51.83 ± 13.07 years)were included in the study group. Treatment ledto significant decrease in all investigated parameters, with a clinical and functional improvement at week 48. No major sideeffects were detected. Conclusions: decreasing disease activity and improving functional, with no major side effects in 1 yearperiod, rituximab may represents the solution for refractory rheumatoid arthritis cases. Further studies on larger groups arerequired.