INTRODUCTION: The value of antineutrophil cytoplasmic antibody (ANCA) measurements among patients with an established diagnosis of ANCA-associated vasculitis (AAV) to assess disease activity or predict relapse remains controversial, but recent evidence suggests a possible role for rituximab-treated patients. PATIENTS AND METHODS: All patients with active vasculitis and positive proteinase 3 (PR3)-ANCA who were starting a 2-year treatment course of rituximab for induction of remission at Addenbrooke's Hospital between January 2011 and January 2016 were included in this study. Common department practice consists of 6 g of rituximab given over 2 years, concomitant corticosteroids (0.5-1.0 mg/kg) with rapid taper over 3 months, and cessation of oral maintenance immunosuppressive agents at time of first rituximab dose. Clinical and laboratory data were collected retrospectively using electronic patient records. RESULTS: Fifty-seven patients with current PR3-ANCA positivity were included in the analysis. Median follow-up was 59 months. PR3-ANCA negativity was achieved in 25 patients (44%) with a median time of 14 months. Clinical remission was achieved in 53 patients (93%) with a median time of 3 months. Among the 53 patients who achieved remission during follow-up, 24 (45%) relapsed with a median time to relapse of 36 months from remission. Both PR3-ANCA-negative status and 50% reduction in PR3-ANCA from baseline (as time-varying covariates) were significantly associated with a longer time to relapse (PR3-ANCA-negative status: hazards ratio, 0.08 [95% confidence interval, 0.01-0.63, p = 0.016]; 50% reduction in PR3-ANCA: hazards ratio, 0.25 [95% confidence interval, 0.18-0.99, p = 0.046]). CONCLUSIONS: Achieving and maintaining PR3-ANCA negativity after rituximab was associated with longer-lasting remission.
INTRODUCTION: The value of antineutrophil cytoplasmic antibody (ANCA) measurements among patients with an established diagnosis of ANCA-associated vasculitis (AAV) to assess disease activity or predict relapse remains controversial, but recent evidence suggests a possible role for rituximab-treated patients. PATIENTS AND METHODS: All patients with active vasculitis and positive proteinase 3 (PR3)-ANCA who were starting a 2-year treatment course of rituximab for induction of remission at Addenbrooke's Hospital between January 2011 and January 2016 were included in this study. Common department practice consists of 6 g of rituximab given over 2 years, concomitant corticosteroids (0.5-1.0 mg/kg) with rapid taper over 3 months, and cessation of oral maintenance immunosuppressive agents at time of first rituximab dose. Clinical and laboratory data were collected retrospectively using electronic patient records. RESULTS: Fifty-seven patients with current PR3-ANCA positivity were included in the analysis. Median follow-up was 59 months. PR3-ANCA negativity was achieved in 25 patients (44%) with a median time of 14 months. Clinical remission was achieved in 53 patients (93%) with a median time of 3 months. Among the 53 patients who achieved remission during follow-up, 24 (45%) relapsed with a median time to relapse of 36 months from remission. Both PR3-ANCA-negative status and 50% reduction in PR3-ANCA from baseline (as time-varying covariates) were significantly associated with a longer time to relapse (PR3-ANCA-negative status: hazards ratio, 0.08 [95% confidence interval, 0.01-0.63, p = 0.016]; 50% reduction in PR3-ANCA: hazards ratio, 0.25 [95% confidence interval, 0.18-0.99, p = 0.046]). CONCLUSIONS: Achieving and maintaining PR3-ANCA negativity after rituximab was associated with longer-lasting remission.
Authors: X Kyndt; D Reumaux; F Bridoux; B Tribout; P Bataille; E Hachulla; P Y Hatron; P Duthilleul; P Vanhille Journal: Am J Med Date: 1999-05 Impact factor: 4.965
Authors: Alexandre Karras; Christian Pagnoux; Marion Haubitz; Kirsten de Groot; Xavier Puechal; Jan Willem Cohen Tervaert; Mårten Segelmark; Loic Guillevin; David Jayne Journal: Ann Rheum Dis Date: 2017-05-25 Impact factor: 19.103
Authors: David Jayne; Niels Rasmussen; Konrad Andrassy; Paul Bacon; Jan Willem Cohen Tervaert; Jolanta Dadoniené; Agneta Ekstrand; Gill Gaskin; Gina Gregorini; Kirsten de Groot; Wolfgang Gross; E Christiaan Hagen; Eduardo Mirapeix; Erna Pettersson; Carl Siegert; Alberto Sinico; Vladimir Tesar; Kerstin Westman; Charles Pusey Journal: N Engl J Med Date: 2003-07-03 Impact factor: 91.245
Authors: Pierre Charles; Benjamin Terrier; Élodie Perrodeau; Pascal Cohen; Stanislas Faguer; Antoine Huart; Mohamed Hamidou; Christian Agard; Bernard Bonnotte; Maxime Samson; Alexandre Karras; Noémie Jourde-Chiche; François Lifermann; Pierre Gobert; Catherine Hanrotel-Saliou; Pascal Godmer; Nicolas Martin-Silva; Grégory Pugnet; Marie Matignon; Olivier Aumaitre; Jean-François Viallard; François Maurier; Nadine Meaux-Ruault; Sophie Rivière; Jean Sibilia; Xavier Puéchal; Philippe Ravaud; Luc Mouthon; Loïc Guillevin Journal: Ann Rheum Dis Date: 2018-04-25 Impact factor: 19.103
Authors: Paul A Lyons; Tim F Rayner; Sapna Trivedi; Julia U Holle; Richard A Watts; David R W Jayne; Bo Baslund; Paul Brenchley; Annette Bruchfeld; Afzal N Chaudhry; Jan Willem Cohen Tervaert; Panos Deloukas; Conleth Feighery; Wolfgang L Gross; Loic Guillevin; Iva Gunnarsson; Lorraine Harper; Zdenka Hrušková; Mark A Little; Davide Martorana; Thomas Neumann; Sophie Ohlsson; Sandosh Padmanabhan; Charles D Pusey; Alan D Salama; Jan-Stephan F Sanders; Caroline O Savage; Mårten Segelmark; Coen A Stegeman; Vladimir Tesař; Augusto Vaglio; Stefan Wieczorek; Benjamin Wilde; Jochen Zwerina; Andrew J Rees; David G Clayton; Kenneth G C Smith Journal: N Engl J Med Date: 2012-07-19 Impact factor: 91.245
Authors: Adam D Morris; Camilo L M Morais; Kássio M G Lima; Daniel L D Freitas; Mark E Brady; Ajay P Dhaygude; Anthony W Rowbottom; Francis L Martin Journal: Sci Rep Date: 2021-05-11 Impact factor: 4.379
Authors: Laura S van Dam; Ebru Dirikgil; Edwin W Bredewold; Argho Ray; Jaap A Bakker; Cees van Kooten; Ton J Rabelink; Yoe K Onno Teng Journal: Nephrol Dial Transplant Date: 2021-07-23 Impact factor: 5.992
Authors: Rona M Smith; Rachel Bronwen Jones; Ulrich Specks; Simon Bond; Marianna Nodale; Reem Aljayyousi; Jacqueline Andrews; Annette Bruchfeld; Brian Camilleri; Simon Carette; Chee Kay Cheung; Vimal Derebail; Tim Doulton; Lindsy Forbess; Shouichi Fujimoto; Shunsuke Furuta; Ora Gewurz-Singer; Lorraine Harper; Toshiko Ito-Ihara; Nader Khalidi; Rainer Klocke; Curry Koening; Yoshinori Komagata; Carol Langford; Peter Lanyon; Raashid Ahmed Luqmani; Hirofumi Makino; Carole A McAlear; Paul Monach; Larry W Moreland; Kim Mynard; Patrick Nachman; Christian Pagnoux; Fiona Pearce; Chen Au Peh; Charles Pusey; Dwarakanathan Ranganathan; Rennie L Rhee; Robert Spiera; Antoine G Sreih; Vladimir Tesar; Giles Walters; Michael H Weisman; Caroline Wroe; Peter A Merkel; David Jayne Journal: Ann Rheum Dis Date: 2020-06-24 Impact factor: 19.103
Authors: Mark E McClure; Yajing Zhu; Rona M Smith; Seerapani Gopaluni; Joanna Tieu; Tasneem Pope; Karl Emil Kristensen; David R W Jayne; Jessica Barrett; Rachel B Jones Journal: Rheumatology (Oxford) Date: 2021-03-02 Impact factor: 7.580