(1) @entity1499 is often used as a first-line treatment for severe and worsening @entity309 . @entity310 antagonists (etanercept, infliximab and adalimumab) are second-line options. (2) Rituximab, a monoclonal antibody first used to treat @entity706 , is now also approved for the treatment of @entity309 when at least one @entity310 antagonist has failed. (3) There are three available comparative trials including about 1150 @entity309 @entity1 . The results indicate that rituximab is no more effective than @entity1499 ; a combination of rituximab + @entity1499 is more effective than @entity1499 alone (although only about half the @entity1 meet the ACR 20% response criterion); and adding a @entity134 fails to improve effectiveness. (4) The adverse effect profile of rituximab in @entity625 seems similar to that observed in @entity706 . In the short term, the main adverse effects are infusion hypersensitivity reactions, which are more frequent during the first infusion and can be partly prevented by premedication with a @entity134 . The other known risks are mainly infectious and cardiovascular. Follow-up is too short to rule out a possible increase in the risk of @entity5 . Gastrointestinal perforations have occurred in some @entity706 @entity1 treated with rituximab. (5) In practice, when standard treatment fails, adding rituximab to @entity1499 can be beneficial but requires close @entity1 monitoring.

Rituximab: new indication. In XXXX : for a few @entity1 , with close monitoring.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity625 :: ('MESH:D001168', 'Disease') :: ['arthritis'] @entity706 :: ('MESH:D008223', 'Disease') :: ['lymphoma'] @entity310 :: ('7124', 'Gene') :: ['TNF alpha'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity134 :: ('CHEBI:35341', 'Chemical') :: ['steroid'] @entity1499 :: ('MESH:D008727', 'Chemical') :: ['Methotrexate', 'methotrexate'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis']
@entity309 :: (MESH:D001172,Disease) :: ['rheumatoid arthritis']
