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Vasculitis syndromes

Rituximab in AAV: when and how to use it

Rituximab has emerged as an alternative to cyclophosphamide for remission induction in anti-neutrophil cytoplasmic antibody-associated vasculitides, with recommendations now developed to direct its use in these diseases. However, data from extended clinical trials are required to determine whether rituximab is safer or more efficacious than cyclophosphamide in the long term.

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References

  1. Mukhtyar, C. et al. EULAR recommendations for the management of primary small and medium vessel vasculitis. Ann. Rheum. Dis. 68, 310–317 (2009).

    Article  CAS  Google Scholar 

  2. Hoffman, G. S. et al. Wegener granulomatosis: an analysis of 158 patients. Ann. Intern. Med. 116, 488–498 (1992).

    Article  CAS  Google Scholar 

  3. Stone, J. H. et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N. Engl. J. Med. 363, 221–232 (2010).

    Article  CAS  Google Scholar 

  4. Jones, R. B. et al. Rituximab versus cyclophopshamide in ANCA-associated renal vasculitis. N. Engl. J. Med. 363, 211–220 (2010).

    Article  CAS  Google Scholar 

  5. Guerry, M. J. et al. Recommendations for the use of rituximab in anti-neutrophil cytoplasm antibody-associated vasculitis. Rheumatology (Oxford) http://dx.doi.org/10.1093/rheumatology/ker150.

  6. Holle, J. U. et al. Improved outcome in 445 patients with Wegener's granulomatosis in a German vasculitis center over four decades. Arthritis Rheum. 63, 257–266 (2011).

    Article  Google Scholar 

  7. Holle, J. U. et al. Retrospective study of Rituximab (RTX) in refractory Granulomatosis with Polyangiitis (Wegener's) (WG): Comparison of treatment response in vasculitis versus granulomatous manifestations [abstract OP0055]. Ann. Rheum. Dis. 70 (Suppl. 3), 85 (2011).

    Google Scholar 

  8. Hellmich, B. et al. EULAR recommendations for conducting clinical studies and/or clinical trials in systemic vasculitis: focus on anti-neutrophil cytoplasm antibody-associated vasculitis. Ann. Rheum. Dis. 66, 605–617 (2007).

    Article  CAS  Google Scholar 

  9. Little, M. A. et al. Early mortality in systemic vasculitis: relative contribution of adverse events and active vasculitis. Ann. Rheum. Dis. 69, 1036–1043 (2010).

    Article  Google Scholar 

  10. Ntatsaki, E., Mooney, J. & Watts, R. A. ANCA vasculitis: time for a change in treatment paradigm? Not yet. Rheumatology (Oxford) 50, 1019–1024 (2011).

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank Prof. Stefan Gadola, Professor of Immunology/Consultant Rheumatologist, Department of Infection, Inflammation and Immunity, Faculty of Medicine and Health and Life Sciences, School of Medicine, University of Southampton, for his valuable contribution to this manuscript.

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Correspondence to Julia U. Holle.

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Competing interests

J. U. Holle has received speaker's fees from Roche. W. L. Gross has received speaker's fees from and is a stockholder in Roche.

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Supplementary Table 1

Recommendations for the use of rituximab in AAV by Guerry et al.5 (DOC 63 kb)

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Holle, J., Gross, W. Rituximab in AAV: when and how to use it. Nat Rev Rheumatol 7, 566–567 (2011). https://doi.org/10.1038/nrrheum.2011.131

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