Vasculitis & polymyalgia rheumatica
Maintenance of remission of antineutrophil cytoplasmic antibody (ANCA) vasculitis by rituximab based on B cell repopulation versus serological flare: a randomised trial
Authors' conclusion
Rituximab dosed for B cell repopulation results in fewer clinical relapses than when dosed for a rise in ANCA level in maintenance of remission for ANCA vasculitis. Overall safety was equivalent; SAEs due to COVID-19 and rituximab exposure were higher with the B cell strategy.
Study context
- Population
- Patients with ANCA vasculitis in remission after completing at least 2 years of fixed-schedule RTXmedian follow-up 4.1 years
- Participants
- 115 patients
- Comparison
- RTX reinfused upon B cell repopulation vs upon significant rise in ANCA level
- Primary endpoint
- Clinical relapse, defined as a modified BVAS/WG >0
- Follow-up
- 36 months
Methodological detailsprospective, single-centre, open-label
- Prospective
- Single-centre
- Open-label
Primary result
As reported in the abstract
Clinical relapse (Kaplan-Meier) · 3 years after study entry
Log-rank p=0.045
Secondary outcomes
| Outcome | B cell | ANCA | P value |
|---|---|---|---|
| RTX exposure, infusions per person · median follow-up 4.1 years | mean 3.6 (SD 2.4) infusions (3.6 g) | mean 0.5 (SD 1.4) infusions (0.5 g) | P < 0.001 |
Safety
| Outcome | P value |
|---|---|
| SAEs due to COVID-19Higher in the B cell arm | P = 0.049 |
Total serious adverse events (SAEs), including infectious SAEs, and deaths
- Did not differ
Original publication
Maintenance of remission of ANCA vasculitis by rituximab based on B cell repopulation versus serological flare: a randomised trial. Ann Rheum Dis. Published 15 February 2024. doi:10.
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