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Treatment with secukinumab results in a higher rate of remission or low-disease activity at week 16 in patients with psoriatic arthritis as compared with placebo, according to a posthoc analysis of the FUTURE 2 study. This effect is sustained at 2 years and is evident in both tumour necrosis factor inhibitor-experienced and -naïve patients.

Rituximab a promising option in JIA patients failing other therapies

24 Nov 2018

Rituximab appears to be effective in the treatment of children with juvenile idiopathic arthritis (JIA) who have not responded to a tumour necrosis factor inhibitor (TNFi), a study has shown. Moreover, serious infection rates are low.

The present analysis included a real-world cohort of 41 JIA patients within the UK Biologics for Children with Rheumatic Diseases study initiating rituximab. Assessments included disease activity (at baseline and follow-up), the total number of courses each patient received, and serious infections and infusion reactions following treatment.

The median age of the cohort was 15 years, and 80 percent were female. Most of the patients had polyarthritis—rheumatoid factor (RF)-negative polyarthritis (35 percent), RF-positive polyarthritis (33 percent) or extended oligoarthritis (23 percent)—with a median disease duration of 9 years.

From rituximab initiation, the clinical Juvenile Arthritis Disease Activity Score (cJADAS; three-variable 71-joint JADAS) improved by a median of 9 units (IQR, −14 to 2; n=7). More than half of the patients received more than one course of treatment: 17 (41 percent) had one, 12 (29 percent) had two, seven (17 percent) had three, and five (12 percent) had four or more. The median time between each treatment course was 219 days (IQR, 198–315).

During follow-up, 17 patients (41 percent) reported switching to another biologic, including tocilizumab (n=8), abatacept (n=6) and TNFi (n=3).

In terms of safety, three patients (7 percent) developed a serious infection on rituximab, yielding a first serious infection rate of 6.2 per 100 person-years. There were four patients (10 percent) who had an infusion reaction.

The present data, although reassuring, highlight a need for a clinical trial of rituximab to establish clear efficacy and safety in patients with JIA, as well as to identify in which International League of Associations for Rheumatology (ILAR) categories the drug may be most effective, researchers said.

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Most Read Articles
04 Feb 2019
The carbon-chain length of saturated fatty acids appears to be an important factor in determining its role in cardiovascular health, a recent study has found.
6 days ago
Olanzapine confers a modest therapeutic effect on weight compared with placebo in adult outpatients with anorexia nervosa, a study has shown. However, it does not appear to offer significant benefit for psychological symptoms.
Pearl Toh, 3 days ago
A latest study at ISC 2019 shows that even patients with large-core stroke damage can have a good outcome after mechanical clot removal with endovascular thrombectomy (EVT), depending on the size of the infarct and time lapses between stroke onset and treatment.
Jairia Dela Cruz, 04 Feb 2019
Treatment with secukinumab results in a higher rate of remission or low-disease activity at week 16 in patients with psoriatic arthritis as compared with placebo, according to a posthoc analysis of the FUTURE 2 study. This effect is sustained at 2 years and is evident in both tumour necrosis factor inhibitor-experienced and -naïve patients.