Vasculitis & polymyalgia rheumatica
Predictors of hypogammaglobulinemia in ANCA-associated vasculitis after a rituximab-based induction: a multicentre study
Authors' conclusion
In AAV patients treated with rituximab, hypogammaglobulinemia at 6 months after induction is common, and lower IgG levels are associated with serious infections. The risk of hypogammaglobulinemia in these patients increases with age and higher glucocorticoid doses.
Study context
- Population
- ANCA-associated vasculitis (AAV) patients treated with RTX induction in 14 European centres
- Participants
- 227 patients
- Outcome
- Predictors of IgG levels and of hypogammaglobulinemia (IgG ≤7 g/l)
- Follow-up
- 6 months
Methodological detailsmulticentre, linear and logistic regression
- Multicentre
- Linear and logistic regression
Main finding
As reported in the abstract
Hypogammaglobulinemia, n (%)
97
42.7%
Age, OR per 10 years (95% CI), multivariable
1.46
1.15, 1.86P = 0.002
Oral GC dose at induction, OR per 10 mg prednisone (95% CI), multivariable
1.52
1.23, 1.89P < 0.001
Observational data: associations, not effects.
Further findings
Predictors of IgG levels at 6 months (linear regression)
- Age, β per 10 years
- −0.23 (−0.38, −0.08), P = 0.003 (95% CI)
- Oral GC dose at induction, β per sqrt-transformed mg prednisone
- −0.37 (−0.51, −0.24), P < 0.001 (95% CI)
- Concomitant IV GC pulses, β
- −0.88 (−1.73, −0.02), P = 0.044 (95% CI)
IgG levels at 6 months vs baseline
- Lower than baseline
- P < 0.001
IgG levels at 6 months in patients requiring IV antibiotics during first 6 months
- Lower IgG levels
- P = 0.004
Original publication
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