Información del artículo
Abstract
Introduction
Rituximab has been employed successfully for the treatment of Rheumatoid Arthritis (RA). However, its particular mechanism of action, as well as a lack of concrete guidelines for its management have generated doubts on its use.
ObjectiveTo establish recommendations that facilitate the use of rituximab in common clinical practice.
MethodsIn a first Delphi round, 9 expert rheumatologists got together to develop questions on those subjects generating most doubts on the efficacy and safety of the drug. These were adapted to perform a systematic review of the evidence, which was presented in a second meeting. Nominal groups were formed to respond to each question and give a recommendation. These recommendations were presented in a second Delphi round to a larger group of experts in rheumatology. Once again recommendations were discussed, modified and voted upon. Once approved, a vote on the degree of agreement for each recommendation was carried out.
ResultsSeventeen recommendations were established, 10 regarding efficacy and 7 safety. All of the efficacy recommendations except 3 presented a good or moderate degree of evidence. Among the safety recommendations, 3 had a good or moderate degree of evidence while in the rest it was indirect, scarce or non-existent and a product of expert recommendation. The degree of agreement between experts was elevated for most of the recommendations.
ConclusionsThese recommendations attempt to clear doubts on the use of rituximab and establish guidelines for its use in daily practice. Efficacy recommendations have a high degree of evidence, allowing the clinician to be guided in therapeutic decisions. Safety recommendations have a lower degree of evidence.
Keywords:
Rheumatoid arthritis
Rituximab
Biologic therapy
Consensus
Resumen
Introducción
El rituximab se ha empleado con éxito en el tratamiento de la artritis reumatoide (AR). Sin embargo, su particular mecanismo de acción, así como la ausencia de pautas concretas en su manejo, hace que se hayan generado dudas sobre su utilización.
ObjetivoEstablecer recomendaciones que faciliten el empleo de rituximab en la práctica clínica habitual.
MétodosEn una primera ronda Delphi, se reunieron nueve reumatólogos expertos que desarrollaron preguntas sobre los temas con mayor duda sobre eficacia y seguridad del fármaco. Estas se adecuaron para hacer una revisión sistemática de la evidencia, que se presentó en una segunda reunión. Se formaron grupos nominales para dar respuesta a cada pregunta y emitir la recomendación. Estas recomendaciones fueron presentadas en una segunda ronda Delphi a un grupo ampliado de reumatólogos expertos. De nuevo se discutieron, se modificaron y se votaron las recomendaciones. Una vez aprobada cada recomendación, se votó el grado de acuerdo.
ResultadosSe establecieron 17 recomendaciones: diez de eficacia y siete de seguridad. Todas las recomendaciones de eficacia, excepto tres, presentaron un nivel de evidencia bueno o moderado. Entre las recomendaciones de seguridad, tres presentaron un nivel de evidencia bueno o moderado, mientras que para el resto la evidencia fue indirecta, escasa o nula y son producto de las recomendaciones de los expertos. El grado de acuerdo entre expertos fue elevado para la mayoría de las recomendaciones.
ConclusionesEstas recomendaciones pretenden aclarar dudas sobre el uso de rituximab y establecer pautas de empleo en la práctica clínica. Las recomendaciones de eficacia tienen un nivel de evidencia alto y permiten guiar al médico en decisiones terapéuticas. Las recomendaciones de seguridad tienen un nivel de evidencia menor..
Palabras clave:
Artritis reumatoide
Rituximab
Terapias biológicas
Consenso
El Texto completo está disponible en PDF
References
[1.]
M.E. Reff, K. Carner, K.S. Chambers, P.C. Chinn, J.E. Leonard, R. Raab, et al.
Depletion of B cells in vivo by a chimeric mouse human monoclonal antibody to CD20.
Blood, 83 (1994), pp. 435-445
[2.]
D.R. Anderson, A. Grillo-Lopez, C. Varns, K.S. Chambers, N. Hanna.
Targeted anti-cancer therapy using rituximab, a chimaeric anti-CD20 antibody (IDEC-C2B8) in the treatment of non-Hodgkin's B-cell lymphoma.
Biochem Soc Trans., 25 (1997), pp. 705-708
[3.]
J.C. Edwards, G. Cambridge.
Sustained improvement in rheumatoid arthritis following a protocol designed to deplete B lymphocytes.
Rheumatology (Oxford)., 40 (2001), pp. 205-211
[4.]
J.C. Edwards, L. Szczepanski, J. Szechinski, A. Filipowicz-Sosnowska, P. Emery, D.R. Close, et al.
Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis.
N Engl J Med., 350 (2004), pp. 2572-2581
[5.]
J.S. Smolen, E.C. Keystone, P. Emery, F.C. Breedveld, N. Betteridge, G.R. Burmester, et al.
Consensus statement on the use of rituximab in patients with rheumatoid arthritis.
Ann Rheum Dis., 66 (2007), pp. 143-150
[6.]
J. Tornero, R. Sanmartí, V. Rodríguez-Valverde, E. Martín-Mola, J.L. Marenco, I. González-Alvaro, et al.
Actualización del documento de consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas en la artritis reumatoide.
Reumatol Clin., 6 (2010), pp. 23-36
[7.]
K. Fitch, S.J. Bernstein, M.S. Aguilar, B. Burnand, J.R. LaCalle, P. Lazaro, et al.
The RAND/UCLA appropriateness method user's manual.
RAND, (2001),
[8.]
P. Tugwell, M. Boers.
Developing consensus on preliminary core efficacy endpoints for rheumatoid arthritis clinical trials. OMERACT Committee.
J Rheumatol., 20 (1993), pp. 555-556
[9.]
Oxford center for evidence based medicine levels of evidence. 2009. Available from: http://www.cmbd.net
[10.]
J.S. Smolen, D. Aletaha, J.W. Bijlsma, F.C. Breedveld, D. Boumpas, G. Burmester, et al.
Treating rheumatoid arthritis to target: recommendations of an international task force.
Ann Rheum Dis., 69 (2010), pp. 631-637
[11.]
P. Emery, R. Fleischmann, A. Filipowicz-Sosnowska, J. Schechtman, L. Szczepanski, A. Kavanaugh, et al.
The efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment: results of a phase IIB randomized, double-blind, placebo-controlled, dose-ranging trial.
Arthritis Rheum., 54 (2006), pp. 1390-1400
[12.]
P. Emery, A. Deodhar, W.F. Rigby, J.D. Isaacs, B. Combe, A.J. Racewicz, et al.
Efficacy and safety of different doses and retreatment of rituximab: a randomised, placebo-controlled trial in patients who are biological naive with active rheumatoid arthritis and an inadequate response to methotrexate (Study Evaluating Rituximab's Efficacy in MTX iNadequate rEsponders [SERENE]).
Ann Rheum Dis., 69 (2010), pp. 1629-1635
[13.]
A. Rubbert-Roth, P.P. Tak, C. Zerbini, J.L. Tremblay, L. Carreno, G. Armstrong, et al.
Efficacy and safety of various repeat treatment dosing regimens of rituximab in patients with active rheumatoid arthritis: results of a Phase III randomized study (MIRROR).
Rheumatology (Oxford)., (2010),
[14.]
P.P. Tak, W.F. Rigby, A. Rubbert-Roth, et al.
Inhibition of joint damage and improved clinical otcomes with a combination of rituximab (RTX) and methotrexate (MTX) in patients (PTS) with early active rheumatoid arthritis (RA) who are naive to MTX: a randomised active comparator placebo-controlled trial [abstract].
Ann Rheum Dis., 68 (2009), pp. 75
[15.]
A. Rubbert-Roth, A. Finckh.
Treatment options in patients with rheumatoid arthritis failing initial TNF inhibitor therapy: a critical review.
Arthritis Res Ther., 11 (2009), pp. S1
[16.]
A. Finckh, A. Ciurea, L. Brulhart, B. Moller, U.A. Walker, D. Courvoisier, et al.
Which subgroup of patients with rheumatoid arthritis benefits from switching to rituximab versus alternative anti-tumour necrosis factor (TNF) agents after previous failure of an anti-TNF agent?.
Ann Rheum Dis., 69 (2010), pp. 387-393
[17.]
L. Quartuccio, M. Fabris, S. Salvin, F. Atzeni, M. Saracco, M. Benucci, et al.
Rheumatoid factor positivity rather than anti-CCP positivity, a lower disability and a lower number of anti-TNF agents failed are associated with response to rituximab in rheumatoid arthritis.
Rheumatology (Oxford)., 48 (2009), pp. 1557-1559
[18.]
H. Valleala, M. Korpela, T. Mottonen, T. Hienonen-Kempas, M. Kauppi, P. Hannonen, et al.
Rituximab therapy in patients with rheumatoid arthritis refractory or with contraindication to anti-tumour necrosis factor drugs: real-life experience in Finnish patients.
Scand J Rheumatol., 38 (2009), pp. 323-327
[19.]
S.B. Cohen, P. Emery, M.W. Greenwald, M. Dougados, R.A. Furie, M.C. Genovese, et al.
Rituximab for rheumatoid arthritis refractory to anti-tumor necrosis factor therapy: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial evaluating primary efficacy and safety at twenty-four weeks.
Arthritis Rheum., 54 (2006), pp. 2793-2806
[20.]
S.B. Cohen, E. Keystone, M.C. Genovese, P. Emery, C. Peterfy, P.P. Tak, et al.
Continued inhibition of structural damage over 2 years in patients with rheumatoid arthritis treated with rituximab in combination with methotrexate.
Ann Rheum Dis., 69 (2010), pp. 1158-1161
[21.]
J. Kremer, H.P. Tony, P.P. Tak, et al.
Efficacy of rituximab in active RA patients with an inadecuate response to one or more TNF inhibitors [abstract].
Arthritis Rheum., 54 (2006), pp. S247
[22.]
M.H. Buch, E.M. Vital, S. Dass, S. Das, D. Bryer, P. Emery.
Switching to RTX and an alternative TNF inhibitor in patients with rheumatoid arthritis (RA) that have failed previous TNF inhibitor(s) are both effective treatment options with good maintenance rates [abstract].
Ann Rheum Dis., 69 (2010), pp. 379
[23.]
J. Gómez-Reino, R. Sanmartí, A. Azpeitia.
Rituximab compared with further tumour necrosis factor (TNF) antagonist therapy in rheumatoid arthritis (RA) patients who had previously failed TNF antagonist therapy: results of a prospective, observational study [abstract].
Ann Rheum Dis., 68 (2009), pp. 442
[24.]
P.P. Tak, S. Cohen, P. Emery, et al.
Baseline autoantibody status (RF, anti-CCP) and clinical response following the first treatment course with rituximab [abstract].
Arthritis Rheum., 54 (2006), pp. 833
[25.]
P.P. Tak, S. Cohen, P. Emery, et al.
Clinical response following the first treatment course with rituximab: effect of baseline autoantibody status (RF, anti-CCP) (abstract).
Ann Rheum Dis., 66 (2007), pp. 338
[26.]
J.D Isaacs, E. Olech, P.P. Tak, et al.
Autoantibody-positive rheumatoid arthritis (RA) patients (PTS) have enhanced clinical response to rituximab (RTX) when compared with seronegative patients [abstract].
Ann Rheum Dis., 68 (2009), pp. 442
[27.]
X. Mariette, A. Kivitz, J.D. Isaacs, W. Stohl, P.P. Tak, R.E. Jones.
Effectiveness of rituximab (RTX), methotrexate (MTX) in patients (pts) with early active rheumatoid arthritis (RA) and disease characteristics associated with poor outcomes [abstract].
Arthritis Rheum., 60 (2009), pp. 1687
[28.]
S Dass, E.M. Vital, M.H. Buch, A.C. Rawstron, S. Bingham, F. Ponchel, et al.
Effect of concomitant DMARD on B cell depletion with rituximab in rheumatoid arthritis [abstract].
Ann Rheum Dis., 68 (2009), pp. 579
[29.]
K. Owczarczyk, M. Hellmann, G. Fliedner, T. Rohrs, K. Maizus, D. Passon, et al.
Clinical outcome and B cell depletion in patients with rheumatoid arthritis receiving rituximab monotherapy in comparison with patients receiving concomitant methotrexate.
Ann Rheum Dis., 67 (2008), pp. 1648-1649
[30.]
W.A. Schmidt, B. Schicke, A. Krause, D. Wernicke.
How effective is rituximab in rheumatoid arthritis? Lessons learned from clinical practice [abstract].
Ann Rheum Dis., 68 (2009), pp. 741
[31.]
C. Prudhomme, E. Solau-Gervais, P. Phillippe, E. Houvenagel, J. Legrand, R. Flipo.
Rheumatoid arthritis treated with rituximab in the real life: efficacy depend on rheumatoid factor positivity but not on methotrexate association or previous treatment with anti-TNF alpha [abstract].
Ann Rheum Dis., 68 (2009), pp. 438
[32.]
J. Wendler, H. Soerensen, H. Tony, et al.
Effectiveness and safety of rituximab (RTX)- monotherapy compared to RTX-combination therapy with methotrexate (MTX) or leflunomide (LEF) in the german RTX treatment of active rheumatoid arthritis (RA) in daily practice trial [abstract].
Ann Rheum Dis., 68 (2009), pp. 76
[33.]
J.C. Henes, J. Schedel, L. Kanz, I. Koetter.
Rituximab and concomitant leflunomide for the treatment of rheumatoid arthritis.
Rheumatol Int., 30 (2010), pp. 709-712
[34.]
E.M. Vital, S. Dass, A.C. Rawstron, P. Emery.
Combination rituximab and leflunomide produces lasting responses in rheumatoid arthritis.
Ann Rheum Dis., 67 (2008), pp. 90
[35.]
W.F. Rigby, G. Ferraccioli, M. Greenwald, B. Montiel, R. Fleischmann, S. Wassenberg, et al.
Rituximab improved physical function and quality of life in patients with early rheumatoid arthritis: results from randomized active comparator placebo-controlled trial of rituximab in combination with methotrexate compared to methotrexate alone in patients naive to methotrexate (Image study) [abstract].
Ann Rheum Dis., 68 (2009), pp. 581
[36.]
P.J. Mease, S. Cohen, N.B. Gaylis, A. Chubick, A.T. Kaell, M. Greenwald, et al.
Efficacy and safety of retreatment in patients with rheumatoid arthritis with previous inadequate response to tumor necrosis factor inhibitors: results from the SUNRISE trial.
J Rheumatol., 37 (2010), pp. 917-927
[37.]
E. Keystone, R. Fleischmann, P. Emery, M. Dougados, A. Baldassare, G. Armstrong, et al.
Multiple courses of rituximab (RTX) produce sustained efficacy in patients (pts) with rheumatoid arthritis (RA) with an inadequate response (IR) to one or more TNF inhibitors [abstract].
Arthritis Rheum., 60 (2009), pp. 1683
[38.]
E. Keystone, R. Fleischmann, P. Emery, D.E. Furst, V.R. Van, J. Bathon, et al.
Safety and efficacy of additional courses of rituximab in patients with active rheumatoid arthritis: an open-label extension analysis.
Arthritis Rheum., 56 (2007), pp. 3896
[39.]
MabThera's Technical Card. Hoffman La Roche; 2009.
[40.]
Y.K. Teng, J. Tekstra, F.C. Breedveld, F. Lafeber, J.W. Bijlsma, J.M. Van Laar.
Rituximab fixed retreatment versus on-demand retreatment in refractory rheumatoid arthritis: comparison of two B cell depleting treatment strategies.
Ann Rheum Dis., 68 (2009), pp. 1075-1077
[41.]
J. Tekstra, O. Teng, P.M. Welsing, J.M. Van Laar, F. Lafeber, J.W. Bijlsma.
Comparision of clinical outcome in rheumatoid arthritis patients treated with a fixed or ondemand regime of rituximab: two year follow up [abstract].
Arthritis Rheum., 60 (2009), pp. 680
[42.]
P. Emery, P.J. Maese, A. Rubbert-Roth, J.R. Curtis, U. Muller-Ladner, N.B. Gaylis, et al.
Retreatment with rituximab (RTX) based on a treatment to target (TT) approach provides better disease control than treatment as needed (PRN) in patients (pts) with rheumatoid arthritis (RA).
Arthritis Rheum., 60 (2009), pp. 2013
[43.]
R.M. Thurlings, K. Vos, D.M. Gerlag, P.P. Tak.
Disease activity-guided rituximab therapy in rheumatoid arthritis: the effects of re-treatment in initial nonresponders versus initial responders.
Arthritis Rheum., 58 (2008), pp. 3657-3664
[44.]
E.M. Vital, S. Dass, A.C. Rawstron, M.H. Buch, V. Goeb, K. Henshaw, et al.
Management of nonresponse to rituximab in rheumatoid arthritis: predictors and outcome of re-treatment.
Arthritis Rheum., 62 (2010), pp. 1273-1279
[45.]
M.H. Buch, E.M. Vital, S. Dass, D. Bryer, P. Emery.
Switching to rituximab and an alternative inhibitor in patients with rheumatoid arthritis (RA) that have failed previous TNF inhibitor(s) are both effective treatment options with good maintenance rates.
Ann Rheum Dis., 69 (2010), pp. 379
[46.]
Y.K. Teng, E.W. Levarht, M. Hashemi, I.M. Bajema, R.E. Toes, T.W. Huizinga, et al.
Immunohistochemical analysis as a means to predict responsiveness to rituximab treatment.
Arthritis Rheum., 56 (2007), pp. 3909-3918
[47.]
Y.K. Teng, E.W. Levarht, R.E. Toes, T.W. Huizinga, J.M. Van Laar.
Residual inflammation after rituximab treatment is associated with sustained synovial plasma cell infiltration and enhanced B cell repopulation.
Ann Rheum Dis., 68 (2009), pp. 1011-1016
[48.]
G. Cambridge, W. Stohl, M.J. Leandro, T.S. Migone, D.M. Hilbert, J.C. Edwards.
Circulating levels of B lymphocyte stimulator in patients with rheumatoid arthritis following rituximab treatment: relationships with B cell depletion, circulating antibodies, and clinical relapse.
Arthritis Rheum., 54 (2006), pp. 723-732
[49.]
S. Dass, A.C. Rawstron, E.M. Vital, K. Henshaw, D. McGonagle, P. Emery.
Highly sensitive B cell analysis predicts response to rituximab therapy in rheumatoid arthritis.
Arthritis Rheum., 58 (2008), pp. 2993-2999
[50.]
R.M. Thurlings, O. Teng, K. Vos, D.M. Gerlag, L. Aarden, S.O. Stapel, et al.
Clinical response, pharmacokinetics, development of human anti-chimaeric antibodies, and synovial tissue response to rituximab treatment in patients with rheumatoid arthritis.
Ann Rheum Dis., 69 (2010), pp. 409-412
[51.]
M. Nakou, G. Katsikas, P. Sidiropoulos, G. Bertsias, E. Papadimitraki, A. Raptopoulou, et al.
Rituximab therapy reduces activated B cells in both the peripheral blood and bone marrow of patients with rheumatoid arthritis: depletion of memory B cells correlates with clinical response.
Arthritis Res Ther., 11 (2009), pp. R131
[52.]
R.F. Van Vollenhoven, P. Emery, C.O. Bingham III, E.C. Keystone, R. Fleischmann, D.E. Furst, et al.
Longterm safety of patients receiving rituximab in rheumatoid arthritis clinical trials.
J Rheumatol., 37 (2010), pp. 558-567
[53.]
J. Gottenberg, P. Ravaud, T. Bardin, P. Cacoub, A. Cantagrel, B. Combe, et al.
Risk factors of severe infections in patients with rheumatoid arthritis treated with rituximab in the AutoImmunity and Rituximab (AIR) registry.
Arthritis Rheum., 62 (2010), pp. 2625-2632
[54.]
A.S. Van, A. Holvast, C.A. Benne, M.D. Posthumus, M.A. Van Leeuwen, A.E. Voskuyl, et al.
Humoral responses after influenza vaccination are severely reduced in patients with rheumatoid arthritis treated with rituximab.
Arthritis Rheum., 62 (2010), pp. 75-81
[55.]
S. Oren, M. Mandelboim, Y. Braun-Moscovici, D. Paran, J. Ablin, I. Litinsky, et al.
Vaccination against influenza in patients with rheumatoid arthritis: the effect of rituximab on the humoral response.
Ann Rheum Dis., 67 (2008), pp. 937-941
[56.]
C.O. Bingham III, R.J. Looney, A. Deodhar, N. Halsey, M. Greenwald, C. Codding, et al.
Immunization responses in rheumatoid arthritis patients treated with rituximab: results from a controlled clinical trial.
Arthritis Rheum., 62 (2010), pp. 64-74
[57.]
M.C. Genovese, F.C. Breedveld, P. Emery, S. Cohen, E. Keystone, E.L. Matteson, et al.
Safety of biological therapies following rituximab treatment in rheumatoid arthritis patients.
Ann Rheum Dis., 68 (2009), pp. 1894-1897
[58.]
M. Greenwald, W. Shergy, J.L. Kaine, M.T. Seewtser, K. Gilder, M.D. Linnik.
Safety of rituximab in combination with a TNF inhibitor and methotrexate in patients with active rheumatoid arthritis: results from a randomized controlled trial (TAME) [abstract].
Arthritis Rheum., 60 (2009), pp. 1957
[59.]
A. Strangfeld, F. Hierse, J. Listing, J. Kekow, C. Richter, H. Tony, et al.
RA patients treated with rituximab−routine care data of the german biologics register RABBIT [abstract].
Arthritis Rheum., 58 (2008), pp. 371
[60.]
T. Bongartz, A.J. Sutton, M.J. Sweeting, I. Buchan, E.L. Matteson, V. Montori.
Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials.
JAMA., 295 (2006), pp. 2275-2285
[61.]
A. Strangfeld, R. Rau, G. Burmester, C. Bungartz, E. Wilden, J. Listing, et al.
No increased risk of solid tumours in patients treated with biologics [abstract].
Arthritis Rheum., 58 (2008), pp. 1010
[62.]
J. Askling, R.F. Van Vollenhoven, F. Granath, P. Raaschou, C.M. Fored, E. Baecklund, et al.
Cancer risk in patients with rheumatoid arthritis treated with anti-tumor necrosis factor alpha therapies: does the risk change with the time since start of treatment?.
Arthritis Rheum., 60 (2009), pp. 3180-3189
[63.]
F. Wolfe, K. Michaud.
Biologic treatment of rheumatoid arthritis and the risk of malignancy: analyses from a large US observational study.
Arthritis Rheum., 56 (2007), pp. 2886-2895
[64.]
S. Setoguchi, D.H. Solomon, M.E. Weinblatt, J.N. Katz, J. Avorn, R.J. Glynn, et al.
Tumor necrosis factor alpha antagonist use and cancer in patients with rheumatoid arthritis.
Arthritis Rheum., 54 (2006), pp. 2757-2764
[65.]
P. Raaschou, J. Askling, F. Granath, C.M. Fored.
Are cancers occurring in RA patients treated with TNF-antagonists particularly aggressive? [abstract].
Arthritis Rheum., 56 (2007), pp. 1344
[66.]
L. Carmona, M.A. Descalzo, E. Pérez-Pampín, D. Ruiz-Montesinos, A. Erra, T. Cobo, et al.
All-cause and cause-specific mortality in rheumatoid arthritis are not greater than expected when treated with tumour necrosis factor antagonists.
Ann Rheum Dis., 66 (2007), pp. 880-885
[67.]
N. Assous, L. Gossec, P. Dieude, O. Meyer, M. Dougados, A. Kahan, et al.
Rituximab therapy in rheumatoid arthritis in daily practice.
J Rheumatol., 35 (2008), pp. 31-34
[68.]
F. Wolfe, K. Michaud.
The use of biologic therapy in patients with RA and existing cancer.
Arthritis Rheum., 54 (2006),
[69.]
A.R. Tonelli, R. Lottenberg, R.W. Allan, P.S. Sriram.
Rituximab-induced hypersensitivity pneumonitis.
Respiration., 78 (2009), pp. 225-229
[70.]
R. Ram, I. Ben-Bassat, O. Shpilberg, A. Polliack, P. Raanani.
The late adverse events of rituximab therapy−rare but there!.
Leuk Lymphoma., 50 (2009), pp. 1083-1095
[71.]
S.W. Lim, D. Gillis, W. Smith, P. Hissaria, H. Greville, C.A. Peh.
Rituximab use in systemic lupus erythematosus pneumonitis and a review of current reports.
Intern Med J., 36 (2006), pp. 260-262
[72.]
D. McGonagle, A.L. Tan, J. Madden, A.C. Rawstron, A. Rehman, P. Emery, et al.
Successful treatment of resistant scleroderma-associated interstitial lung disease with rituximab.
Rheumatology (Oxford)., 47 (2008), pp. 552-553
[73.]
W.H. Yoo.
Successful treatment of steroid and cyclophosphamide-resistant diffuse scleroderma-associated interstitial lung disease with rituximab.
Rheumatol Int., (2010),
[74.]
B. Tengstrand, S. Ernestam, I.L. Engvall, Y. Rydvald, I. Hafstrom.
[TNF blockade in rheumatoid arthritis can cause severe fibrosing alveolitis. Six case reports].
Lakartidningen., 102 (2005), pp. 3788-3790
[75.]
A. Schoe, N.E. Van der Laan-Baalbergen, T.W. Huizinga, F.C. Breedveld, J.M. Van Laar.
Pulmonary fibrosis in a patient with rheumatoid arthritis treated with adalimumab.
Arthritis Rheum., 55 (2006), pp. 157-159
[76.]
W. Yeo, P.J. Johnson.
Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy.
Hepatology., 43 (2006), pp. 209-220
[77.]
W. Yeo, T.C. Chan, N.W. Leung, W.Y. Lam, F.K. Mo, M.T. Chu, B. Hepatitis, et al.
virus reactivation in lymphoma patients with prior resolved hepatitis B undergoing anticancer therapy with or without rituximab.
J Clin Oncol., 27 (2009), pp. 605-611
[78.]
S.N. Pei, C.H. Chen, C.M. Lee, M.C. Wang, M.C. Ma, T.H. Hu, et al.
Reactivation of hepatitis B virus following rituximab-based regimens: a serious complication in both HBsAg-positive and HBsAg-negative patients.
Ann Hematol., 89 (2010), pp. 255-262
[79.]
S. Aksoy, H. Harputluoglu, S. Kilickap, D.S. Dede, O. Dizdar, K. Altundag, et al.
Rituximab-related viral infections in lymphoma patients.
Leuk Lymphoma., 48 (2007), pp. 1307-1312
[80.]
A. Pyrpasopoulou, S. Douma, T. Vassiliadis, S. Chatzimichailidou, A. Triantafyllou, S. Aslanidis.
Reactivation of chronic hepatitis B virus infection following rituximab administration for rheumatoid arthritis.
Rheumatol Int., (2009),
[81.]
Hernández Cruz B, García Arias M, Ariza Ariza R, Martín Mola E. Rituximab en artritis reumatoide. Una revisión sistemática. Reumatol Clin. In press 2010.
Copyright © 2011. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
