Severe refractory rheumatoid arthritis successfully treated with combination rituximab and anti-tumor necrosis factor-alpha-blocking agents.

摘要

To the Editor:Despite the efficacy of anti-tumor necrosis factor-alpha (TNF-alpha) agents in rheumatoid arthritis (RA), about 30% of patients seem to have no response or no sustained response. Other drugs such as rituximab have proven efficacy in refractory RA including in patients resistant to anti-TNF, However, clinical experience shows that some patients may not respond to both therapies. We describe 2 patients with very severe refractory RA who failed to respond to anti-TNF or rituximab used alone, but who strikingly responded to the combination of rituximab and anti-TNF with sustained remission and good tolerance.