This randomized, double-blind, placebo controlled, parallel group study will assess the efficacy and safety of rituximab \[MabThera/Rituxan\] in patients with severe active rheumatoid arthritis refractory to at least one anti-TNF treatment, using magnetic resonance imaging (MRI) of the hand for efficacy measurement. Patients will be randomized to receive 2 intravenous infusions 14 days apart of either 1000mg MabThera (group A) or placebo (group B). All patients will receive methotrexate 10-25mg weekly. Patients in group A demonstrating clinical response at week 24 may receive further cycles of MabThera, patients in group B without clinical response will also be treated with active MabThera. Anticipated time on study treatment is up to 2 years. Target sample size is \<50 patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
2
1000 mg by i.v. infusion on day 1 and 15
i.v. infusion on day 1 and 15
10-25 mg weekly
1000 mg by i.v. infusion on day 1 and 15, 2nd and further cycles in patients with (group A) or without (group B) clinical response in cycle 1
Unnamed facility
Barcelona, Barcelona, Spain
Bone erosion score on magnetic resonance imaging (MRI) using the rheumatoid arthritis magnetic resonance imaging scoring system (RAMRIS)
Time frame: 6 months
Synovitis score on MRI using RAMRIS
Time frame: months 6, 12 and 24
Bone edema score on MRI using RAMRIS
Time frame: months 6, 12 and 24
Bone erosion score on MRI using RAMRIS
Time frame: months 12 and 24
Disease activity according to DAS28-CRP
Time frame: months 12 and 24
Tender or swollen joint count (ACR criteria)
Time frame: months 12 and 24
Health assessment questionnaire (HAQ)
Time frame: months 12 and 24
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