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10.1093/rheumatology/keu452

http://scihub22266oqcxt.onion/10.1093/rheumatology/keu452
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suck abstract from ncbi


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pmid25477054      Rheumatology+(Oxford) 2015 ; 54 (7): 1153-60
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  • Long-term follow-up of patients who received repeat-dose rituximab as maintenance therapy for ANCA-associated vasculitis #MMPMID25477054
  • Alberici F; Smith RM; Jones RB; Roberts DM; Willcocks LC; Chaudhry A; Smith KG; Jayne DR
  • Rheumatology (Oxford) 2015[Jul]; 54 (7): 1153-60 PMID25477054show ga
  • OBJECTIVE: ANCA-associated vasculitis (AAV) is characterized by a chronic relapsing course. Rituximab (RTX) is an effective maintenance treatment; however, the long-term outcomes after its discontinuation are unclear. The aim of this study was to explore the long-term outcomes of AAV patients treated with repeat-dose RTX maintenance therapy. METHODS: AAV patients receiving a RTX treatment protocol consisting of an induction and maintenance phase were included. For initial remission induction, RTX was dosed at 1 g every 2 weeks or 375 mg/m(2) weekly for 4 consecutive weeks and for remission maintenance at 1 g every 6 months for 24 months. At the first RTX administration, ongoing immunosuppressives were withdrawn. RESULTS: Sixty-nine patients were identified, 67 of whom were failing other therapies. Nine relapsed during the RTX treatment protocol; however, all 69 were in remission at the end of the maintenance phase on a median prednisolone dose of 2.5 mg/day and 9% were receiving additional immunosuppression. During subsequent observation, 28 patients relapsed a median of 34.4 months after the last RTX infusion. Risk factors for relapse were PR3-associated disease (P = 0.039), B cell return within 12 months of the last RTX infusion (P = 0.0038) and switch from ANCA negativity to positivity (P = 0.0046). Two patients died and two developed severe hypogammaglobulinaemia. CONCLUSION: This study supports the efficacy and safety of a fixed-interval RTX maintenance regimen in relapsing/refractory AAV. Relapses after discontinuation of maintenance therapy did occur, but at a lower rate than after a single RTX induction course. PR3-associated disease, the switch from ANCA negative to positive and the return of B cells within 12 months of the last RTX administration were risk factors for further relapse.
  • |Adult[MESH]
  • |Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug therapy[MESH]
  • |Antibodies, Monoclonal, Murine-Derived/*administration & dosage/adverse effects/*therapeutic use[MESH]
  • |Antirheumatic Agents/*administration & dosage/adverse effects/*therapeutic use[MESH]
  • |Cohort Studies[MESH]
  • |Dose-Response Relationship, Drug[MESH]
  • |Drug Administration Schedule[MESH]
  • |Drug Therapy, Combination[MESH]
  • |Female[MESH]
  • |Follow-Up Studies[MESH]
  • |Humans[MESH]
  • |Immunosuppressive Agents/administration & dosage/therapeutic use[MESH]
  • |Incidence[MESH]
  • |Longitudinal Studies[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Prednisolone/administration & dosage/therapeutic use[MESH]
  • |Recurrence[MESH]
  • |Retrospective Studies[MESH]
  • |Rituximab[MESH]
  • |Time Factors[MESH]


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