Eficacia de Infliximab versus Rituximab en el tratamiento de la artritis reumatoide: revisión sistemática

Abstract

Optimal dosing of biologics for rheumatoid arthritis (RA) remains undefined, contributing to clinical variability. The objective was to evaluate the efficacy of Infliximab and Rituximab (bDMARDs) to identify dosing regimens that maximize outcomes and safety. A PRISMA 2020 systematic review was conducted in PubMed, Scopus, Web of Science, and Springer, focusing on studies from the last 10 years that met the ACR 20/50/70 criteria. Reviews, meta-analyses, and gray literature were excluded. The risk of bias was assessed using the RoB 2 tool. Infliximab 10 mg/kg every 8 weeks demonstrated the highest clinical response; 6 mg/kg provided a balance between efficacy and safety. Rituximab at 2 × 1000 mg reduced activity more than 2 × 500 mg, although the advantage was modest. Both therapies were administered with methotrexate to enhance the response. However, unrepresentative populations make broad extrapolation difficult. In conclusion, both drugs are viable therapies; infliximab is faster-acting, while rituximab is useful after prior treatment failures. The choice should be individualized, considering impact, cost, and tolerance to optimize quality of life. Keywords: Infliximab, Rituximab, dosing, effectiveness