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Rituxan Treats Rheumatoid Arthritis

Study Shows Low Doses of Rituxan as Effective as Higher Doses

Testing Rituxan continued...

The study is published in the May issue of the journal Arthritis and Rheumatism. It was funded by drug makers Genentech, Biogen, and Hoffmann-La Roche, which market the drug jointly. Genentech and Biogen are WebMD sponsors.

There were nine different treatment groups, designed to better understand which doses of drugs were most effective and whether adding steroids improved outcomes.

A total of 55% of the patients treated with the higher-dose Rituxan regimen showed a 20% or better improvement after six months, compared with 54% of patients on the low-dose regimen and 28% of patients taking a placebo.

Steroids, whether given in the vein or by mouth, didn't add any further improvement than Rituxan and methotrexate alone. But intravenous steroids given prior to Rituxan made the drug more tolerable.

Lower Doses, Fewer Steroids?

These finding suggest that high doses of steroids, which have many side effects when used long term, may not be needed in these patients.

Rheumatologist Simon Helfgott, MD, tells WebMD that this comes as no surprise. Helfgott treats rheumatoid arthritis patients at Brigham and Women's Hospital in Boston; he says about 40% of his patients are on biologics.

"Those of us who have been using this drug and following this understand that you don't need to give the whopping doses of steroids that were used in the early trials," he says.

He says Rituxan is emerging as a useful therapy for patients who fail treatment with the tumor necrosis factor (TNF)-targeting biologics, such as Enbrel, Humira and Remicade.

"The difference in its mode of action is intriguing," he says. "Some patients strike out on all of the anti-TNF agents. It will be interesting to see how they respond to this drug."

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