Behandlingseffekt av rituximab jämfört med infliximab vid reumatoid artrit
The aim of this study was to compare the effect between the drugs rituximab and infliximab in rheumatoid arthritis (RA). RA is an autoimmune disease that affects the peripheral joints and is associated with exacerbations. Various immune reactions in the body cause inflammation of the joints which further results in cartilage and bone damage. The diagnosis is made by the classification system "The 2010 American College of Rheumatology (ACR) / European league against rheumatism (EULAR) classification criteria for rheumatoid arthritis", which is an update of the older system called "The 1987 American College of Rheumatology classification criteria for RA". Approximately 0.5-1% of the population is developing the disease, but it varies slightly between different parts of the world. The disease is 2-3 times more common in women and the median age of onset is 60 years.Methotrexate is the first line drug for treatment of RA, but in more severe disease, monoclonal antibodies such as infliximab and rituximab are used. Infliximab and rituximab are only used for combination therapy with methotrexate. Infliximab is a tumor necrosis factor (TNF) ? inhibitor, while rituximab inhibits B cells.The method for this work was study of literature. The Pubmed database was used and the following terms were used as keywords: "Rheumathoid Arthritis", "Rheumatoid Arthritis rituximab" and "Rheumatoid Arthritis infliximab." A total of 6 studies were elected, 3 for each drug.When evaluating the results it should be kept in mind that the study approaches vary. The study endpoints were ACR 20, ACR 50, ACR 70 and disease activity score (DAS) 28. Based on these measurements there were no significant difference between the drugs. ACR 20 for infliximab was reached by 50 %, 62.4 % and 59.4 % of the patients, respectively in three different studies. ACR 20 for rituximab was reached by 50.6 %, 51 % and 73 % of the patients in three different studies. The DAS 28 reduction for infliximab was 2.6 and 2.3, while the same numbers for rituximab were 1.6, 1.9 and 2.6.In conclusion, both rituximab and infliximab are good treatment options for severe RA. Because of the small difference between the drugs in the results, other aspects become more important. For example, costs and safety profile should be further investigated.