2327 Wendling, et al: RTX for SpA Personal non-commercial use only. The Journal of Rheumatology Copyright © 2012. All rights reserved. Rituximab Treatment for Spondyloarthritis. A Nationwide Series: Data from the AIR Registry of the French Society of Rheumatology DANIEL WENDLING, MAXIME DOUGADOS, FRANCIS BERENBAUM, OLIVIER BROCQ, THIERRY SCHAEVERBEKE, BERNARD MAZIERES, CHRISTIAN MARCELLI, JEAN-MARIE LePARC, PHILIPPE BERTIN, MICHÈLE ROBIN, JEAN SIBILIA, PIERRE LAFFORGUE, CLÉMENT PRATI, BERNARD COMBE, and JACQUES-ERIC GOTTENBERG, on behalf of the French Society of Rheumatology and the Club Rhumatismes et Inflammation ABSTRACT. Objective. To evaluate the efficacy and safety of rituximab (RTX) in several subsets of spondy- loarthritis (SpA) using the data of the AIR (Autoimmunity and Rituximab) registry. Methods. All patients receiving RTX for SpA, and prospectively included in the AIR registry from September 2005 to September 2010, were retrospectively analyzed. The response to treatment was evaluated by the Bath Ankylosing Spondylitis Disease Activity Index for axial disease, joint count for peripheral disease, and C-reactive protein reduction. Results. Among the 595 patients included in the AIR registry, 26 patients with SpA from 13 centers were reported: ankylosing spondylitis (10), undifferentiated SpA (7), and psoriatic arthritis (9). Mean disease duration was 8.8 years (range 1-40). The extraarticular features found were psoriasis, 12 cases; uveitis, 4 cases; and Crohn’s disease, 3 cases. The mean number of disease-modifying antirheumatic drugs before RTX was 2.4; previous anti-tumor necrosis factor (TNF) agents were taken in 23 cases. The mean number of RTX courses was 1.5 (range 1-5), with a total of 35.6 patient-years. Efficacy was noted in 11/23 cases: 3 out of 3 anti-TNF-naive patients and 8 out of 20 anti-TNF nonresponder patients. No predictive factors of response could be identified, particularly in diagnosis subsets or clinical presentation (axial or peripheral). Conclusion. In this nationwide study of several subsets of SpA, RTX had only a moderate efficacy that was more marked in patients who were anti-TNF-naive. (First Release Aug 15 2012; J Rheumatol 2012;39:2327–31; doi:10.3899/jrheum.120201) Key Indexing Terms: RITUXIMAB SPONDYLOARTHRITIS PSORIATIC ARTHRITIS ANKYLOSING SPONDYLITIS AIR REGISTRY From the Department of Rheumatology, CHU de Besançon, and EA 4266, Université de Franche-Comté, Besançon; Paris-Descartes University, Paris; AP-HP, Cochin Hospital, Rheumatology B Department, Paris; Pierre et Marie Curie University, AP-HP Saint Antoine Hospital, Rheumatology, Paris, France; Princess Grace Hospital, Monaco; CHU Pellegrin, Rheumatology, Bordeaux; CHU Rangueil, Rheumatology, Toulouse; CHU, Rheumatology, Caen; AP-HP, Ambroise Paré Hospital, Rheumatology, Boulogne-Billancourt; CHU, Rheumatology, Limoges; General Hospital, Internal Medicine, Laon; CHU, Rheumatology, Strasbourg; CHU, Rheumatology, Marseille; and CHU, Rheumatology, Montpellier, France. The AIR registry was supported by an unrestricted grant from Roche France. D. Wendling, MD, PhD, Department of Rheumatology, CHU de Besançon, and EA 4266, Université de Franche-Comté; M. Dougados, MD, Paris-Descartes University, Medicine Faculty, AP-HP, Cochin Hospital, Rheumatology B Department; F. Berenbaum, MD, PhD, Paris-Pierre et Marie Curie University, AP-HP Saint Antoine Hospital, Rheumatology; O. Brocq, MD, Princess Grace Hospital; T. Schaeverbeke, MD, PhD, CHU Pellegrin, Rheumatology; B. Mazieres, CHU Rangueil, Rheumatology; C. Marcelli, MD, CHU, Rheumatology, Caen; J-M. LeParc, MD, AP-HP, Ambroise Paré Hospital, Rheumatology; P. Bertin, MD, CHU, Rheumatology, Limoges; M. Robin, MD, General Hospital, Internal Medicine, Laon; J. Sibilia, MD, PhD, CHU, Rheumatology, Strasbourg; P. Lafforgue, MD, CHU, Rheumatology, Marseille; C. Prati, MD, Department of Rheumatology, CHU de Besançon, and Université de Franche-Comté; B. Combe, MD, PhD, CHU, Rheumatology, Montpellier; J-E. Gottenberg, MD, PhD, CHU, Rheumatology, Strasbourg. Address correspondence to Dr. D. Wendling, Rheumatology, CHU, Boulevard Fleming, F-25030, Besançon, France. E-mail: dwendling@chu-besancon.fr Accepted for publication June 21, 2012. The concept of spondyloarthritis (SpA) encompasses sever- al entities such as ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis (PsA), inflammatory bowel dis- ease (IBD)-associated arthritis, and undifferentiated SpA. B lymphocytes may be implicated in the immune modifica- tions associated with the disease 1,2 . Elevated immuno- globulin A (IgA) levels have been demonstrated in AS and correlated with disease activity 3 . In addition, B lymphocyte infiltrates were found in zygapophyseal joints of patients with AS, in association with inflammatory magnetic reso- nance imaging (MRI) lesions 4 . Rituximab (RTX) is a monoclonal chimeric antibody directed against CD20 and targeting the B lymphocyte. Data about RTX use in SpA are scant, with few case www.jrheum.org Downloaded on February 17, 2022 from