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- W2910393943 abstract "Background: Rituximab (RTX) is approved for the treatment of rheumatoid arthritis (RA), but there is a large inter-individual variability in clinical response. A better response was previously associated with a decrease in CD4+ T cell counts [1, 2]. Objectives: This study aimed at analyzing the contribution of CD4+ T cell decrease in the clinical response in RA patients treated with RTX. Methods: In this retrospective monocentric observational study, 52 patients were assessed. All patients had received 2 infusions of 1000 mg of RTX 2 weeks apart. Disease activity score in 28 joints (DAS28) was used as clinical endpoint. RTX serum concentrations, peripheral blood CD4+ counts, and DAS28 were measured before and after each RTX infusion and at 3, 6 and 9 months after last infusion. A population PK-PD model, including a physiological turnover and direct response model, was developed to estimate the probability of CD4+ counts decrease. The turnover model was used to describe the effect of RTX on CD4+ T-cell counts, and the direct model was used to describe both RTX and CD4 + T cell count effect on DAS28. Results: The probability of CD4+ counts decrease was estimated at 0.75. Patients with a CD4+ decrease had a higher xDAS28 than the patients without CD4+ decrease, with a maximal xDAS28 of -1.34 and -0.64 in patients with and without CD4+ cell decrease, respectively. Moreover, at M6, patients with CD4+ cell decrease had a median DAS28 of 3.5 (IQR: 2.7 – 4.4), among them 39.5 % with low disease activity (DAS28≤3.2) and 22.3 % in remission (DAS28 Conclusions: This is the first study to quantify the contribution of CD4+ T cell decrease to the clinical response in RA patients treated with RTX. References [1] Melet J, et al. Rituximab-induced T cell depletion in patients with rheumatoid arthritis: association with clinical response. Arthritis Rheum2013. [2] Lavielle M, et al. Repeated decrease of CD4+ T-cell counts in patients with rheumatoid arthritis over multiple cycles of rituximab treatment. Arthritis Res Ther2016. Disclosure of Interest: A. Bensalem: None declared, D. Mulleman Grant/research support from: Abbvie and Nordic Pharma, Consultant for: MSD, Novartis, UCB and Pfizer, G. Thibault: None declared, N. Azzopardi: None declared, G. Paintaud Grant/research support from: Novartis, Roche Pharma, Genzyme, MSD, Chugai and Pfizer, P. Goupille Consultant for: Abbvie, Biogaran, BMS, Hospira, Janssen-Cilag, MSD, Pfizer, Sanofi-Genzyme and UCB, D. Ternant Consultant for: Amgen and Sanofi" @default.
- W2910393943 created "2019-01-25" @default.
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- W2910393943 date "2018-06-01" @default.
- W2910393943 modified "2023-09-25" @default.
- W2910393943 title "SAT0176 Contribution of cd4+ t cells decrease on clinical response to rituximab in rheumatoid arthritis" @default.
- W2910393943 doi "https://doi.org/10.1136/annrheumdis-2018-eular.6926" @default.
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