Anti tümör nekroz faktör alfa tedavilere dirençli veya yan etki gelişen romatoid artrit olgularında rituksimabin etkinlik ve güvenilirliği
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Date
2011-08-12
Authors
Çefle, Ayşe
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada, anti tümör nekroz faktör alfa (antiTNFα) tedavilere yeterli yanıt alınamayan veya yan etki gelişen romatoid artrit (RA) olgularında rituksimab (RIT) kullanımının etkinlik ve güvenilirliği değerlendirilmiştir. Çalışmaya 22 RA’lı olgu alınmıştır. RIT öncesi ve sonrası (3. ay) hastalık aktivitesi (DAS 28 skoru), akut faz reaktanları ile RIT öncesi kullanılan antiTNFα tedavi sayısı ve RIT tedavisine bağlı yan etkiler incelenmiştir. Yirmiiki olgunun 18’i romatoid faktör pozitif idi. Onyedi hastada antiTNFα tedavi yanıtsızlığı, 2 olguda malignite gelişimi ve 3 olguda antiTNFα tedaviye bağlı diğer yan etkiler nedeniyle RIT uygulandı. Ortalama 3. ayda yapılan kesitsel değerlendirmede DAS 28 skorlarında anlamlı düşme saptandı. Birinci kür RIT tedavisi sonrası başlangıca göre DAS 28 skorlarında 5,8 den 4,8’e (n=15, p=0,007), 2. kür RIT tedavisi sonrası başlangıca göre DAS 28 skorlarında 5,9 dan 4,3’e (n=9, p=0,008) gerileme gözlendi. RIT tedavisi süresince hiçbir olguda ciddi, tedaviyi sonlandırmayı gerektiren bir yan etki gözlenmedi. Sonuç olarak, RA’da RIT deneyimimiz, antiTNFα tedavilere dirençli veya yan etki geliştiren olgularda, RIT’ın etkili ve güvenilir olduğunu göstermektedir.
In this study, we evaluated the efficiency and safety of rituximab (RIT) treatment in patients with rheumatoid arthritis(RA) who were inadequate responders to anti tumor necrosis alpha (antiTNFα) agents or patients that can not tolerate antiTNFα agents because of adverse events. Twenty two patients with RA were enrolled to the study. Disease activity score(DAS 28) before and after (3. month) the RIT treatment, acute phase reactants, number of antiTNFα agents before RIT therapy and adverse events were analysed. Rheumatoid factor was positive in 18 of the 22 patients. Seventeen of the 22 patients were inadequate responders to antiTNFα agents, 2 patients developed malignancy and in 3 patients antiTNFα agents could not be used due to other adverse events. In cross sectional analysis of the 3. month, a significant decrease was seen in DAS28 from 5,9 to 4,8 (n=15, p<0,05) and after the second cure of RIT treatment DAS28 score was decreased from the starting score of 5,9 to 4,3 (n=9, p<0,05).No serious adverse event was noted after RIT treatment. In conclusion, our experience in patients with RA, RIT is an efficient and safe biologic agent for anti TNFα refractory patients or patients that can not receive antiTNFα agents for some reasons.
In this study, we evaluated the efficiency and safety of rituximab (RIT) treatment in patients with rheumatoid arthritis(RA) who were inadequate responders to anti tumor necrosis alpha (antiTNFα) agents or patients that can not tolerate antiTNFα agents because of adverse events. Twenty two patients with RA were enrolled to the study. Disease activity score(DAS 28) before and after (3. month) the RIT treatment, acute phase reactants, number of antiTNFα agents before RIT therapy and adverse events were analysed. Rheumatoid factor was positive in 18 of the 22 patients. Seventeen of the 22 patients were inadequate responders to antiTNFα agents, 2 patients developed malignancy and in 3 patients antiTNFα agents could not be used due to other adverse events. In cross sectional analysis of the 3. month, a significant decrease was seen in DAS28 from 5,9 to 4,8 (n=15, p<0,05) and after the second cure of RIT treatment DAS28 score was decreased from the starting score of 5,9 to 4,3 (n=9, p<0,05).No serious adverse event was noted after RIT treatment. In conclusion, our experience in patients with RA, RIT is an efficient and safe biologic agent for anti TNFα refractory patients or patients that can not receive antiTNFα agents for some reasons.
Description
Bu çalışma, 10-13 Mart 2011 tarihleri arasında yapılan 7. Uludağ İç Hastalıkları Kongresi’nde sözlü bildiri olarak sunulmuştur.
Keywords
Rituksimab, Romatoid artrit, Rituximab, Anti tümör nekroz faktör alfa, Anti tumor necrosis factor alpha, Rheumatoid arthritis
Citation
Dalkılıç, E. vd. (2011). ''Anti tümör nekroz faktör alfa tedavilere dirençli veya yan etki gelişen romatoid artrit olgularında rituksimabin etkinlik ve güvenilirliği''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 37(3), 127-130.