دوشنبه 19 خرداد 1404
[Archive]
دوره 33، شماره 157 - ( 1-1404 )
جلد 33 شماره 157 صفحات 158-151 |
برگشت به فهرست نسخه ها
Ethics code: IR.SBMU.MSP.REC.1402.538
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Ahmadzadeh A, Farsad F, Rahaei A, Emam M M, Gachkar L, Shafighi Shahri E. Compared Efficacy of Tocilizumab versus Rituximab in the Treatment of Refractory Rheumatoid Arthritis: A Randomized Clinical Trial study. J Adv Med Biomed Res 2025; 33 (157) :151-158
URL: http://journal.zums.ac.ir/article-1-7517-fa.html
URL: http://journal.zums.ac.ir/article-1-7517-fa.html
Compared Efficacy of Tocilizumab versus Rituximab in the Treatment of Refractory Rheumatoid Arthritis: A Randomized Clinical Trial study. Journal of Advances in Medical and Biomedical Research. 1404; 33 (157) :151-158
چکیده: (34 مشاهده)
Background & Aims: This study was carried out to compare the efficacy of tocilizumab versus rituximab in the treatment of refractory rheumatoid arthritis.
Materials & Methods: Twenty-two women with refractory rheumatoid arthritis were randomly divided into rituximab (n= 11) and tocilizumab (n= 11) treatment groups. In the first group, rituximab was injected intravenously at a dose of 1 gram. In the second group, tocilizumab was injected subcutaneously at a dose of 20 mg /2 weeks for 6 months. Before the intervention, intensity was measured according to visual analog scale (VAS), along with vital signs and side effects. After 6 months, the clinical disease activity index (CDAI), pain intensity, tender joint count (TJC for 68 and 28 joints) and swollen joint count (SJC for 66 and 28 joints) were assessed. SPSS version 26 was used for data analysis.
Results: The mean age for rituximab and tocilizumab groups was 54.63 (±10.76) and 49.91 (±11.14) years, respectively. After 6 months of follow-up, the means of TJC (68 and 28 joints), SJC (for 66 and 28 joints), CDAI and pain intensity were not significantly different in the rituximab and tocilizumab groups (P>0.05). However, the mean of all the above-mentioned items before and 6 months after follow-up was statistically significant within each of the rituximab and tocilizumab groups (P<0.05).
Conclusions: The efficacy of tocilizumab and rituximab in the treatment of refractory rheumatoid arthritis was similar, therefore, both drugs can be used to treat these patients.
نوع مطالعه: مقاله پژوهشی |
موضوع مقاله:
Clinical Medicine
دریافت: 1403/11/14 | پذیرش: 1404/1/31 | انتشار: 1404/3/8
دریافت: 1403/11/14 | پذیرش: 1404/1/31 | انتشار: 1404/3/8
فهرست منابع
1. Scherer HU, Häupl T, Burmester GR. The etiology of rheumatoid arthritis. J Autoimmun. 2020;110:102400. [DOI:10.1016/j.jaut.2019.102400] [PMID]
2. Radu AF, Bungau SG. Management of rheumatoid arthritis: an overview. Cells. 2021;10(11):2857. [DOI:10.3390/cells10112857] [PMID] [PMCID]
3. Finckh A, Gilbert B, Hodkinson B, Bae SC, Thomas R, Deane KD, et al. Global epidemiology of rheumatoid arthritis. Nat Rev Rheumatol. 2022;18(10):591-602. [DOI:10.1038/s41584-022-00827-y] [PMID]
4. Steinmetz JD, Culbreth GT, Haile LM, Rafferty Q, Lo J, Fukutaki KG, et al. Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(9):e508-22.
5. Almeida MD, Almeida JV, Bertolo MB. Demographic and clinical features of patients with rheumatoid arthritis in Piaui, Brazil-evaluation of 98 patients. Revista Brasileira de Reumatologia. 2014;54:360-5. [DOI:10.1016/j.rbr.2014.02.005] [PMID]
6. Mok CC. Morning stiffness in elderly patients with rheumatoid arthritis: what is known about the effect of biological and targeted agents?. Drugs Aging. 2018;35:477-83. [DOI:10.1007/s40266-018-0548-0] [PMID]
7. Orange DE, Blachere NE, DiCarlo EF, Mirza S, Pannellini T, Jiang CS, et al. Rheumatoid arthritis morning stiffness is associated with synovial fibrin and neutrophils. Arthritis Rheumatol. 2020;72(4):557-64. [DOI:10.1002/art.41141] [PMID] [PMCID]
8. Zokaei S, Farhud DD, Keykhaei M, Yeganeh MZ, Rahimi H, Moravvej H. Cultured epidermal melanocyte transplantation in vitiligo: a review article. Iran J Public Health. 2019;48(3):388. [DOI:10.18502/ijph.v48i3.881] [PMID] [PMCID]
9. Polido-Pereira J, Vieira-Sousa E, Fonseca JE. Rheumatoid arthritis: what is refractory disease and how to manage it?. Autoimmun Rev. 2011;10(11):707-13. [DOI:10.1016/j.autrev.2011.04.023] [PMID]
10. Romão VC, Fonseca JE. Etiology and risk factors for rheumatoid arthritis: a state-of-the-art review. Front Med. 2021;8:689698. [DOI:10.3389/fmed.2021.689698] [PMID] [PMCID]
11. Alam J, Jantan I, Bukhari SN. Rheumatoid arthritis: recent advances on its etiology, role of cytokines and pharmacotherapy. Biomed Pharmacother. 2017;92:615-33. [DOI:10.1016/j.biopha.2017.05.055] [PMID]
12. Rommer PS, Dörner T, Freivogel K, Haas J, Kieseier BC, Kümpfel T, et al. Safety and clinical outcomes of rituximab treatment in patients with multiple sclerosis and neuromyelitis optica: experience from a national online registry (GRAID). J Neuroimmune Pharmacol. 2016;11:1-8. [DOI:10.1007/s11481-015-9646-5] [PMID]
13. Kanatas P, Stouras I, Stefanis L, Stathopoulos P. B-cell-directed therapies: a new era in multiple sclerosis treatment. Can J Neurol Sci. 2023;50(3):355-64. [DOI:10.1017/cjn.2022.60] [PMID]
14. Holloman JP, Axtell RC, Monson NL, Wu GF. The role of B cells in primary progressive multiple sclerosis. Front Neurol. 2021;12:680581. [DOI:10.3389/fneur.2021.680581] [PMID] [PMCID]
15. Lee DS, Rojas OL, Gommerman JL. B cell depletion therapies in autoimmune disease: advances and mechanistic insights. Nat Rev Drug Discov. 2021;20(3):179-99. [DOI:10.1038/s41573-020-00092-2] [PMID] [PMCID]
16. de Flon P, Laurell K, Söderström L, Gunnarsson M, Svenningsson A. Improved treatment satisfaction after switching therapy to rituximab in relapsing-remitting MS. Mult Scler J. 2017;23(9):1249-57. [DOI:10.1177/1352458516676643] [PMID]
17. Favalli EG. Understanding the role of interleukin-6 (IL-6) in the joint and beyond: a comprehensive review of IL-6 inhibition for the management of rheumatoid arthritis. Rheumatol. Ther. 2020;7(3):473-516. [DOI:10.1007/s40744-020-00219-2] [PMID] [PMCID]
18. Pandolfi F, Franza L, Carusi V, Altamura S, Andriollo G, Nucera E. Interleukin-6 in rheumatoid arthritis. Int J Mol Sci. 2020;21(15):5238. [DOI:10.3390/ijms21155238] [PMID] [PMCID]
19. Pugliesi A, Oliveira AB, Oliveira AB, Xavier R, Mota LM, Bertolo MB, et al. Compared efficacy of rituximab, abatacept, and tocilizumab in patients with rheumatoid arthritis refractory to methotrexate or TNF inhibitors agents: a systematic review and network meta-analysis. Adv Rheumatol. 2023;63:30. [DOI:10.1186/s42358-023-00298-z] [PMID]
20. Saki A, Rajaei E, Rahim F. Safety and efficacy of tocilizumab for rheumatoid arthritis: a systematic review and metaanalysis of clinical trial studies. Rheumatol. 2021;59(3):169-79. [DOI:10.5114/reum.2021.107026] [PMID] [PMCID]
21. Nishimoto N, Miyasaka N, Yamamoto K, Kawai S, Takeuchi T, Azuma J. Long-term safety and efficacy of tocilizumab, an anti-IL-6 receptor monoclonal antibody, in monotherapy, in patients with rheumatoid arthritis (the STREAM study): evidence of safety and efficacy in a 5-year extension study. Ann Rheum Dis. 2009;68(10):1580-4. [DOI:10.1136/ard.2008.092866] [PMID] [PMCID]
22. Humby F, Durez P, Buch MH, Lewis MJ, Rizvi H, Rivellese F, et al. Rituximab versus tocilizumab in anti-TNF inadequate responder patients with rheumatoid arthritis (R4RA): 16-week outcomes of a stratified, biopsy-driven, multicentre, open-label, phase 4 randomised controlled trial. Lancet. 2021;397(10271):305-17. [DOI:10.1016/S0140-6736(20)32341-2] [PMID]
23. Keystone EC, Anisfeld A, Ogale S, Devenport JN, Curtis JR. Continued benefit of tocilizumab plus disease-modifying antirheumatic drug therapy in patients with rheumatoid arthritis and inadequate clinical responses by week 8 of treatment. J Rheumatol. 2014;41(2):216-26. [DOI:10.3899/jrheum.130489] [PMID]
24. Kavanaugh A, Rosengren S, Lee SJ, Hammaker D, Firestein GS, Kalunian K, et al. Assessment of rituximab's immunomodulatory synovial effects (the ARISE trial). I: clinical and synovial biomarker results. Annals of the rheumatic diseases. 2007. Annals of the Rheumatic Diseases. 2008;67(3):402-8. [DOI:10.1136/ard.2007.074229] [PMID] [PMCID]
25. Brown S, Everett CC, Naraghi K, Davies C, Dawkins B, Hulme C, et al. Alternative tumour necrosis factor inhibitors (TNFi) or abatacept or rituximab following failure of initial TNFi in rheumatoid arthritis: the SWITCH RCT. Health Technol Assess. 2018;22(34):1-280. [DOI:10.3310/hta22340]
26. González-Vacarezza N, Alemán A, González G, Pérez A. Rituximab and tocilizumab for the treatment of rheumatoid arthritis. Int J Technol Assess Health Care. 2014;30(3):282-8. [DOI:10.1017/S0266462314000221] [PMID]
27. Gottenberg JE, Morel J, Perrodeau E, Bardin T, Combe B, Dougados M, et al. Comparative effectiveness of rituximab, abatacept, and tocilizumab in adults with rheumatoid arthritis and inadequate response to TNF inhibitors: prospective cohort study. Br Med J. 2019;364:l67. [DOI:10.1136/bmj.l67] [PMID] [PMCID]
| بازنشر اطلاعات | |
 |
این مقاله تحت شرایط Creative Commons Attribution-NonCommercial 4.0 International License قابل بازنشر است. |
