Rituximab May Adversely Affect Immune Function

Studies show the drug decreases RA patients' response to pneumococcal and influenza vaccines
By Rick Ansorge
HealthDay Reporter

THURSDAY, Jan. 14 (HealthDay News) -- In patients with rheumatoid arthritis, treatment with rituximab may adversely affect the response to vaccines, according to two studies in the January issue of Arthritis & Rheumatism.

In one study, Clifton O. Bingham III, M.D., of Johns Hopkins University in Baltimore, and colleagues studied immune responses in 103 rheumatoid arthritis patients who were randomly assigned to receive either rituximab and methotrexate or methotrexate only. They found that rituximab was associated with decreased neoantigen keyhole limpet hemocyanin and T cell-independent responses to pneumococcal vaccine.

In a second study, Sander van Assen, M.D., of the University Medical Center Groningen in the Netherlands, and colleagues studied immune responses to trivalent influenza subunit vaccine in 23 rituximab-treated rheumatoid arthritis patients, 20 methotrexate-treated rheumatoid arthritis patients, and 29 healthy controls. They found that rituximab reduced humoral responses in rheumatoid arthritis patients following vaccination, and observed a modestly restored response six to 10 months after rituximab administration.

"Further studies like those described herein are needed to dissect the complex effects of rituximab therapy on pathologic and protective immune responses to develop strategies that balance effective B cell depletion with the risk of infections," states the author of an accompanying editorial.

The first study was supported by Genentech; several authors reported financial relationships with Genentech and other pharmaceutical companies. The second study was supported by Roche Nederland and Solvay Pharmaceuticals.

Abstract - Bingham
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Abstract - van Assen
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