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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+J+Am+Soc+Nephrol
2014 ; 9
(4
): 736-44
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English Wikipedia
Long-term maintenance therapy using rituximab-induced continuous B-cell depletion
in patients with ANCA vasculitis
#MMPMID24626432
Pendergraft WF 3rd
; Cortazar FB
; Wenger J
; Murphy AP
; Rhee EP
; Laliberte KA
; Niles JL
Clin J Am Soc Nephrol
2014[Apr]; 9
(4
): 736-44
PMID24626432
show ga
BACKGROUND AND OBJECTIVES: Remission in the majority of ANCA vasculitis patients
is not sustained after a single course of rituximab, and risk of relapse warrants
development of a successful strategy to ensure durable remission. DESIGN,
SETTING, PARTICIPANTS, & MEASUREMENTS: A retrospective analysis of ANCA
vasculitis patients who underwent maintenance therapy using rituximab-induced
continuous B-cell depletion for up to 7 years was performed. Maintenance therapy
with rituximab was initiated after achieving remission or converting from other
prior maintenance therapy. Continuous B-cell depletion was achieved in all
patients by scheduled rituximab administration every 4 months. Disease activity,
serologic parameters, adverse events, and survival were examined. RESULTS: In the
study, 172 patients (mean age=60 years, 55% women, 57% myeloperoxidase-ANCA)
treated from April of 2006 to March of 2013 underwent continuous B-cell depletion
with rituximab. Median remission maintenance follow-up time was 2.1 years.
Complete remission (Birmingham Vasculitis Activity Score [BVAS] = 0) was achieved
in all patients. Major relapse (BVAS ? 3) occurred in 5% of patients and was
associated with weaning of other immunosuppression drugs. Remission was reinduced
in all patients. Survival mirrored survival of a general age-, sex-, and
ethnicity-matched United States population. CONCLUSION: This analysis provides
evidence for long-term disease control using continuous B-cell depletion. This
treatment strategy in ANCA vasculitis patients also seems to result in survival
rates comparable with rates in a matched reference population. These findings
suggest that prospective remission maintenance treatment trials using continuous
B-cell depletion are warranted.