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- W2014932015 abstract "To the Editor: Despite the efficacy of anti-tumor necrosis factor-α (TNF-α) agents in rheumatoid arthritis (RA), about 30% of patients seem to have no response or no sustained response1. Other drugs such as rituximab have proven efficacy in refractory RA including in patients resistant to anti-TNF2–5. However, clinical experience shows that some patients may not respond to both therapies. We describe 2 patients with very severe refractory RA who failed to respond to anti-TNF or rituximab used alone, but who strikingly responded to the combination of rituximab and anti-TNF with sustained remission and good tolerance. A 45-year-old woman was diagnosed with RA in 2003, with symmetric polyarthritis of the wrists, with antibodies positive for rheumatoid factor (RF) and anti-cyclic citrullinated protein (CCP) and increased C-reactive protein (68 mg/l). Initial radiographs were normal. Disease remained active despite conventional disease modifying antirheumatic drugs (DMARD) including methotrexate (MTX, 20 mg/week). She did not respond to adalimumab, even used once a week. At that time she presented a very pronounced alteration … Address correspondence to Prof. Allanore; E-mail: yannick.allanore{at}cch.aphp.fr" @default.
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- W2014932015 date "2009-09-01" @default.
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- W2014932015 title "Severe Refractory Rheumatoid Arthritis Successfully Treated with Combination Rituximab and Anti-Tumor Necrosis Factor-α-Blocking Agents" @default.
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- W2014932015 doi "https://doi.org/10.3899/jrheum.090160" @default.
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