Head-to-Head Comparison of Rituximab vs. TNF Inhibitors for Rheumatoid Arthritis

Biologic agents are used to treat patients with rheumatoid arthritis (RA) who do not respond completely to standard treatment with methotrexate and other nonbiologic therapies; however, the optimal biologic for a given patient is not always clear. Both rituximab (Rituxan) and tumor necrosis factor (TNF) inhibitors (e.g., etanercept [Enbrel], adalimumab [Humira]) are effective, but their safety and efficacy have not been compared head-to-head. In this U.K. study, 295 patients with seropositive RA and inadequate responses to ≥2 nonbiologics (including methotrexate) were randomized to rituximab, etanercept, or adalimumab. Disease activity on a standard measure was assessed monthly, and patients could cross over to other treatment groups if the…