Efficacy and Safety of Rituximab in Biologic-Naive Patients with Rheumatoid Arthritis vs Anti-Tnf Therapy Failure

Luis Arturo Gutierrez-Gonzalez*, 1, Marco Antonio Rivera Gudiño1, Ibell Oropeza Ceija2, Marialina Marin Leonet1, Zair Tovar Noguera1Author Comment: (GRUPO GRUVEA: Venezuelan Group for the Study of Rheumatoid Arthritis)

1 Hospital Universitario de Caracas, HUC-UCV, Venezuela
2 Hospital “Dr. José María Vargas”, Caracas, UCV, Venezuela

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© Gutierrez-Gonzalez et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the National Center Rheumatic Diseases (CNER), Hospital Universitario de Caracas, Urbanization Los Chaguaramos, City University UCV, Caracas 1020, Venezuela; Tel: +58212606.7527; Fax: +582126067179; E-mail:



Our aim was to compare an AntiCD20 therapy (rituximab) for rheumatoid arthritis in two patient populations (Group 1), anti-TNFα naïve patients and inadequate responders to Anti-TNFα therapy (Group 2).


We analyzed the efficacy of the drug Rituximab (RTX) in RA patients who failed methotrexate (MTX) or had a relative or absolute contraindication to receive anti-TNFα therapy.


25 patients were identified according to the above criteria and followed up for a mean period of 6 months. Thirteen patients were biologic naïve and twelve patients had already failed anti-TNFα therapy. Group 1 used 2> DMARDs (32% vs 20%, p<0.005), group 2 had more years of disease progression (5±1.89 v s4.10±3.92, p<0.001). The remission as measured by the DAS28 reached faster in group 1 (1.25±0.12 vs 2.15±1.64, p<0,001). Severe infections especially by herpes viruses were more frequent in group 2.


Comparing clinical improvement in both groups the decrease of acute phase reactants and the clinical remission measured by DAS28 was reached in both groups, however it was reached more belatedly in group 2 (at 6 months), this is due to the fact that they have more years of the disease evolution and a higher HAQ.

Keywords: : Rheumatoid arthritis, synthetic DMARDs, biologic DMARDs..