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10.2215/CJN.07340713

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suck abstract from ncbi


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pmid24626432
      Clin+J+Am+Soc+Nephrol 2014 ; 9 (4 ): 736-44
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  • 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.
  • |Adult [MESH]
  • |Aged [MESH]
  • |Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis/*drug therapy/immunology/mortality [MESH]
  • |Antibodies, Monoclonal, Murine-Derived/*administration & dosage/adverse effects [MESH]
  • |B-Lymphocytes/*drug effects/immunology [MESH]
  • |Drug Administration Schedule [MESH]
  • |Female [MESH]
  • |Humans [MESH]
  • |Immunosuppressive Agents/*administration & dosage/adverse effects [MESH]
  • |Infusions, Intravenous [MESH]
  • |Kaplan-Meier Estimate [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Recurrence [MESH]
  • |Remission Induction [MESH]
  • |Retrospective Studies [MESH]
  • |Rituximab [MESH]
  • |Survival Rate [MESH]
  • |Time Factors [MESH]


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