Patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis treated with rituximab currently receive four infusions of 375 mg/m2 (the standard lymphoma schedule). Given that B-cell depletion seems to occur soon after the first dose, would a single dose be effective? A single-centre study of 19 patients (17 with generalized disease and 2 with severe disease [creatinine level >500 μm]) found that satisfactory B-cell depletion occurred following a single dose of rituximab in 89% of patients, after a median of 13 days. The median time to complete remission was 38 days, and the 3-month probability of complete remission was 80%. The median times to B-cell repopulation and to disease relapse/re-dose were 9.2 and 27 months, respectively. The authors conclude that this single-dose protocol is a reasonable and cost-effective approach.
References
Turner-Stokes, T. et al. Induction treatment of ANCA-associated vasculitis with a single dose of rituximab. Rheumatology (Oxford) 10.1093/rheumatology/ket489
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Single dose of rituximab for ANCA-associated vasculitis. Nat Rev Rheumatol 10, 258 (2014). https://doi.org/10.1038/nrrheum.2014.52
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DOI: https://doi.org/10.1038/nrrheum.2014.52