What is it about?
What was already known? Rituximab is not licensed for use in children and young people with juvenile idiopathic arthritis (JIA). However, it is considered a possible treatment option particularly in patients who are rheumatoid factor (RF) positive where previous biologic treatment was ineffective or not tolerated. There remains a question about which, if any, children may benefit from treatment with rituximab. The aim of this current analysis was to describe rituximab use and effectiveness in a national cohort of children and young people with JIA. What was discovered? The Biologics for Children with Rheumatic Diseases (BCRD) cohort study collects data on patients starting biologic therapy for JIA. Between January 2010 and January 2018, 41 patients started rituximab therapy, of which the majority were polyarthritis RF negative (35%), polyarthritis RF positive (33%), or extended oligoarthritis (23%). There was a significant improvement in joint counts and physician assessment in patients 9 months after they started rituximab treatment. Over half of the patients continued therapy after the first course of rituximab, with the next course given after approximately 7 months. However, many of the patients (two-fifths) subsequently reported starting another biologic. Three patients reported a serious infection on rituximab and four patients reported an infusion reaction.
Featured Image
Photo by Frank Wang on Unsplash
Why is it important?
In this real-world cohort of children and young people with JIA, many patients across all ILAR categories have reported exposure to rituximab therapy. Over half of the patients report using rituximab for more than one course indicating potential benefit, with similar improvements in disease activity. These data are reassuring but ultimately, patients with JIA deserve a clinical trial of rituximab therapy to establish clear benefits and safety of the therapy.
Perspectives
This was work originally started by Dr. Sunil Sampath whilst he was completing his PhD at the University of Manchester. I am grateful that I was able to take over the work and expand on his research. We are very proud to have such a large cohort of children and young people on rituximab therapy for JIA.
Dr. Lianne Kearsley-Fleet
University of Manchester
Read the Original
This page is a summary of: Use and effectiveness of rituximab in children and young people with juvenile idiopathic arthritis in a cohort study in the United Kingdom, Rheumatology, October 2018, Oxford University Press (OUP),
DOI: 10.1093/rheumatology/key306.
You can read the full text:
Resources
Contributors
The following have contributed to this page
