Rituximab: the role in the treatment of rheumatoid arthritis

Rituximab is an antibody directed against B cells involved in the inflammatory processes in the course of autoimmune diseases. It is recommended in rheumatoid arthritis (RA) patients with persistent active inflammation despite treatment with classical disease-modifying antirheumatic drugs (DMARDs) and anti-TNF- α agents. In this particular population, its efficacy is higher than that of anti-TNF-α drugs. Rituximab may be used for many years maintaining the same level of efficacy. The most common adverse events are those experienced at the time of drug administration by infusion and are mainly associated with the release of cytokines from B cells. The frequency and intensity of those drug reactions decrease significantly upon premedication with glucocorticosteroids and with each subsequent drug dose. Another type of complications is infections, although their incidence is no higher than in the total population of RA patients. Practical aspects of qualification of patients for treatment as well as the procedure of infusion preparation and administration are also presented.