Treatment with rituximab, a monoclonal antibody targeting CD20+ B cells, could adversely affect immunization responses by dampening the antibody response from new vaccination or reducing pre-formed antibody from prior vaccination. However, little systematic investigation of immunization responses has been undertaken. Here, two studies concurrently published in Arthritis & Rheumatism explore responses after influenza vaccination (van […]
On January 8, 2010, the U.S. Food and Drug Administration approved tocilizumab (to be marketed under the trade name of Actemra) for the treatment of patients with moderate to severe rheumatoid arthritis who have had inadequate clinical responses to treatment with TNF inhibitors. Tocilizumab is a humanized monoclonal antibody directed against the receptor for IL-6, […]
Rheumatoid arthritis disease activity tends to improve during pregnancy, even when disease modifying agents are stopped. However, a minority of women with rheumatoid arthritis will continue to have active disease during pregnancy, and may require additional immunosuppression. Prior studies have yielded conflicting reports on the influence of active disease during pregnancy. Here, de Man et […]
While most observational studies have not demonstrated an increase in malignancy independently associated with TNF inhibitor use, a meta-analysis of short-term clinical trials data suggested an increase in malignancy risk occurring within months of initiating therapy with monoclonal antibodies directed against TNF-α (infliximab and adalimumab).
Initial combination therapy has been shown to be superior to step-up combination therapy in groups of RA patients; however, these findings are difficult to reconcile with the observation that many RA patients will have complete remission of disease on methotrexate alone. Practice patterns tend to emphasize initial treatment with methotrexate monotherapy, followed by the addition of other agents in combination for those with inadequate responses.