Romatoid Artrit Tedavisinde Rituksimab veya Abataceptin Etkinliği ve Güvenirliliği Retrospektif Çalışma

Abstract

Rheumatoid arthritis is an autoimmune disease that characterised with inflammation and damage of joints. It is not clear that which drug will be chosen when there is resistance to anti-TNF drugs, however guidelines of rheumatoid arthritis treatment are updated. This study included, 113 rheumatoid arthritis patients who were matching 1987 ACR criteria and referred to Hacettepe University Medicine Faculty between july 2007 and march 2013, 86 of them used rituximab and 27 of them used abatacept. Data of patient was analysed retrospectively. Rheumatoid factor, anti-CCP, globulin, sedimentation, CRP, DAS28 scores, patient global VAS and doctor global VAS score, HAQ score, swollen and tender joint count, and baseline erosion status of hand-foot x-ray were noted in baseline and follow-up. Patients basically were divided into two groups according to anti-TNF drug use. There was improvement in all parametres of patient using rituximab except HAQ score and anti-CCP in first six mount control. Acute phase response improvement were even achieved in sixth control of rituximab. DAS28-3 ESR and CRP in which patient global VAS score is not counted, was improved statistically significant during five control. Only one patient died because of empyema. There was no serious adverse event with the exception of allergic reactions in %6 of patients. Six mounts follow up ratio was % 92 and one year follow up was %76. When compared with randomised controlled trials and biological registry we found that rituximab is efficient and safe. Patient using abatacept were also analysed like rituximab. Although there was fewer patient, we found statistically significiant improvement of acut phase response, tender and swollen joint count, DAS28-3 scores in first control of 3-6 mounts. There was no serious reactions except acute infusion reactions of % 11 patient. In conclusion, we found that abatacept or rituximab is efficient and safe in rheumatoid arthritis treatment both in anti-TNF and non-biological DMARD resistance.