Add Rituximab to Methotrexate in RA?

June 26, 2015

Adding rituximab to methotrexate improved outcomes in rheumatoid arthritis, without increasing adverse effects. There were some caveats, however.

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.