류마티스 관절염 환자에서 Rituximab 사용에 대한 평가
 
Eun-Han Choo, Eun-Joo Ahn, Hee-Sae Kim, Hye-Sun Gwaka and Young-Chun Song
Department of Pharmacy, Asan Medical Center,
College of Pharmacy, Ewha Women’s Univ.a

Rituximab(RTX), a mouse/human chimeric, monoclonal, anti-CD20 antibody, selectively depletes the B-cell population. Rituximab is approved for treating Rheumatoid arthritis(RA) in patients with an inadequate response to 1 or more TNF inhibitors.
 
We investigate the clinical result of 1 cycle RTX treatment(1000mg on day 1 and 15) with rheumatis patients who had insufficient response to 1 or more TNF inhibitors retrospectively from 2002 to 2012. A total 30 patients enrolled and received RTX.
 
All received intravenous methylprednisolone premedication. The responses were measured by using CRP, ESR. After RTX therapy, there was a measurable decrease of CRP and ESR implicating decrease of active inflammation with synovia. Patients whose CRP or ESR level not decreased over than 20% were classified as non-responders. CRP levels fell by a mean of 1.4 mg/ml between baseline and week 16 in patients treated with rituximab(p<0.05). Sufficient response was achieved by 57% of patients. Relative to baseline, patients who responded to RTX treatment had elevated CRP level compared to patients who didn’t (4.4±3.17 VS. 1.9±1.91, p<0.05). Elevated CRP level identifies a subgroup of patient with RA in whom the benefit of RTX treatment may be enhanced.
 
Most common adverse events were upper respiratory track infection(63%), infusion related adverse event(23%) alopecia(6.6%).
 
주제어 : Rheumatoid artritis Rituximab CRP