Schattner A. ACP Journal Club. Review: In rheumatoid arthritis, adding rituximab to methotrexate improves clinical outcomes. Ann Intern Med. 16 June 2015;162(12):JC9. doi:10.7326/ACPJC-2015-162-12-009
This is a review of -- and commentary on -- the Cochrane review, Rituximab for rheumatoid arthritis.
Cochrane concluded that adding rituximab to methotrexate improved outcomes in rheumatoid arthritis, without increasing adverse effects.
Cochrane had a robust methodological approach, Ami Schattner says. However, the level of evidence was moderate and confidence intervals were wide. Among the limitations:
. Patients in clinical practice differ from those in clinical trials.
. Long-term safety is unknown.
. The optimal dose is unknown, and lower dosages of rituximab may be possible.