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Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis.

Publication ,  Journal Article
Miloslavsky, EM; Specks, U; Merkel, PA; Seo, P; Spiera, R; Langford, CA; Hoffman, GS; Kallenberg, CGM; St Clair, EW; Tchao, NK; Viviano, L ...
Published in: Arthritis Rheumatol
November 2014

OBJECTIVE: Disease relapses are frequent in antineutrophil cytoplasmic antibody-associated vasculitis (AAV). This study was undertaken to evaluate outcomes in patients with AAV who are re-treated with rituximab (RTX) and prednisone for severe disease relapses. METHODS: The Rituximab in AAV trial was a randomized, double-blind, placebo-controlled trial comparing the rates of remission induction among patients treated with RTX (n = 99) and patients treated with cyclophosphamide (CYC) followed by azathioprine (AZA) (n = 98). Prednisone was tapered to discontinuation after 5.5 months. After remission was achieved, patients who experienced a severe disease relapse between months 6 and 18 were eligible to receive RTX and prednisone on an open-label basis according to a prespecified protocol. Investigators remained blinded with regard to the original treatment assignment. RESULTS: Twenty-six patients received RTX for disease relapse after remission had initially been achieved with their originally assigned treatment. Fifteen of these patients were initially randomized to receive RTX and 11 to receive CYC/AZA. Thirteen (87%) of the patients originally assigned to receive RTX and 10 (91%) originally assigned to receive CYC/AZA achieved remission again with open-label RTX (an overall percentage of 88%). In half of the patients treated with open-label RTX, prednisone could be discontinued entirely. Patients in this cohort experienced fewer adverse events compared to the overall study population (4.7 adverse events per patient-year versus 11.8 adverse events per patient-year). CONCLUSION: Re-treatment of AAV relapses with RTX and glucocorticoids appears to be a safe and effective strategy, regardless of previous treatment.

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Published In

Arthritis Rheumatol

DOI

EISSN

2326-5205

Publication Date

November 2014

Volume

66

Issue

11

Start / End Page

3151 / 3159

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Secondary Prevention
  • Rituximab
  • Remission Induction
  • Recurrence
  • Prospective Studies
  • Prednisone
  • Humans
  • Glucocorticoids
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Miloslavsky, E. M., Specks, U., Merkel, P. A., Seo, P., Spiera, R., Langford, C. A., … Rituximab in ANCA-Associated Vasculitis-Immune Tolerance Network Research Group, . (2014). Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol, 66(11), 3151–3159. https://doi.org/10.1002/art.38788
Miloslavsky, E. M., U. Specks, P. A. Merkel, P. Seo, R. Spiera, C. A. Langford, G. S. Hoffman, et al. “Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis.Arthritis Rheumatol 66, no. 11 (November 2014): 3151–59. https://doi.org/10.1002/art.38788.
Miloslavsky EM, Specks U, Merkel PA, Seo P, Spiera R, Langford CA, et al. Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol. 2014 Nov;66(11):3151–9.
Miloslavsky, E. M., et al. “Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis.Arthritis Rheumatol, vol. 66, no. 11, Nov. 2014, pp. 3151–59. Pubmed, doi:10.1002/art.38788.
Miloslavsky EM, Specks U, Merkel PA, Seo P, Spiera R, Langford CA, Hoffman GS, Kallenberg CGM, St Clair EW, Tchao NK, Viviano L, Ding L, Iklé D, Villarreal M, Jepson B, Brunetta P, Allen NB, Fervenza FC, Geetha D, Keogh K, Kissin EY, Monach PA, Peikert T, Stegeman C, Ytterberg SR, Stone JH, Rituximab in ANCA-Associated Vasculitis-Immune Tolerance Network Research Group. Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol. 2014 Nov;66(11):3151–3159.
Journal cover image

Published In

Arthritis Rheumatol

DOI

EISSN

2326-5205

Publication Date

November 2014

Volume

66

Issue

11

Start / End Page

3151 / 3159

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Secondary Prevention
  • Rituximab
  • Remission Induction
  • Recurrence
  • Prospective Studies
  • Prednisone
  • Humans
  • Glucocorticoids