Vasculitis & polymyalgia rheumatica
Relapses and serious adverse events during rituximab maintenance therapy in ANCA-associated vasculitis: a multicentre retrospective study
Authors' conclusion
In this real-world study, relapses during RTX maintenance occurred in approximately 1 out of 4 patients.
Study context
- Population
- Newly diagnosed/relapsing granulomatosis-with-polyangiitis (GPA)/microscopic polyangiitis (MPA) patients receiving rituximab (RTX) maintenance (≥1 RTX cycle, ≥6 months follow-up) after complete remission (BVAS version-3 = 0 plus prednisolone ≤7.5 mg/day) with induction regimens
- Participants
- 101 patients294.5 patient-years
- Outcome
- Incidence of relapses during RTX maintenance
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Relapses during RTX maintenance
Relapses (57% major)
30
Patients with relapse
24
24%
Relapse IR
10.2/100 patient-years
Observational data: associations, not effects.
Further findings
Factors associated with relapse risk (Cox regression)
| aHR (95% CI) | P value | ||
|---|---|---|---|
| Kidney involvementAssociated with decreased relapse risk | 0.20 (0.06–0.74) | P = 0.016 | |
| Shorter time interval until complete remissionAssociated with decreased relapse risk | 1.07 (1.01–1.14) | P = 0.023 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Factors associated with relapse risk (Cox regression)Prior induction with RTX plus CYCvs RTX monotherapyAssociated with decreased relapse risk | 0.02 (0.001–0.43) | P = 0.012 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Safety
Serious adverse events
- Serious infections
- 17 (IR 5.8/100 patient-years)
- COVID-19-associated hospitalizations
- 11 (IR 3.7/100 patient-years)
- Malignancies
- 4 (IR 1.4/100 patient-years)
- Cardiovascular events
- 6 (IR 2/100 patient-years)
- Deaths
- 10 (IR 3.4/100 patient-years)
Original publication
Relapses and serious adverse events during rituximab maintenance therapy in ANCA-associated vasculitis: a multicentre retrospective study. Rheumatology (Oxford). Published 6 August 2024. doi:10.
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