Compared Efficacy of Tocilizumab versus Rituximab in the Treatment of Refractory Rheumatoid Arthritis: A Randomized Clinical Trial study

Background & Objective: This study was carried out to compare the efficacy of tocilizumab versus rituximab in the treatment of refractory rheumatoid arthritis.Materials & Methods: Twenty-two women with refractory rheumatoid arthritis were randomly divided into rituximab (n= 11) and tocilizumab (n= 11) treatment groups.In the first group, rituximab was injected intravenously at a dose of 1 gram.In the second group, tocilizumab was injected subcutaneously at a dose of 20 mg /2 weeks for 6 months.Before the intervention, intensity was measured according to visual analog scale (VAS), along with vital signs and side effects.After 6 months, the clinical disease activity index (CDAI), pain intensity, tender joint count (TJC for 68 and 28 joints) and swollen joint count (SJC for 66 and 28 joints) were assessed.SPSS version 26 was used for data analysis. Results:The mean age for rituximab and tocilizumab groups were 54.63 (10.76) and 49.91 (11.14)years, respectively.After 6 months of follow-up, the means of TJC (68 and 28 joints), SJC (for 66 and 28 joints), CDAI and pain intensity were not significantly different in the rituximab and tocilizumab groups (P>0.05).However, the mean of all the above-mentioned items before and 6 months after follow-up was statistically significant within each of the rituximab and tocilizumab groups (P<0.05). Conclusion:The efficacy of tocilizumab and rituximab in the treatment of refractory rheumatoid arthritis was similar, therefore, both drugs can be used to treat these patients.