[The long-term remission of rheumatoid arthritis with a single cycle of rituximab]

Rituximab selectively targets CD20+ B cells and presumably protects joints in rheumatoid arthritis. Complete remissions after a single treatment with rituximab, in some cases for longer than 1 year, are observed in only the minority of patients. We reported a patient suffering from refractory rheumatoid arthritis who responded to rituximab with sustained remission.

A 78-year-old woman was diagnosed with seropositive rheumatoid arthritis in 2001. The disease remained active despite conventional disease modifying drugs. In February 2007 the disease was highly active. Two infusions of rituximab 1 000 mg on days 1 and 15 were performed. Concomitant treatment consisted of metotrexate 10 mg/week and prednisolone 5 mg/day. The patients were assessed every month after receiving rituximab. Remission was achieved three months later. The patient was retreated with a second cycle of rituximab in December 2009 due to arthritic flare.

This case report showed that the rituximab treatment was feasible and led to a clinically relevant and long lasting improvement in disease activity.