Vasculitis & polymyalgia rheumatica
Rituximab vs Azathioprine for Eosinophilic Granulomatosis With Polyangiitis Maintenance Therapy: A Randomized Clinical Trial
Authors' conclusion
For participants with newly diagnosed or relapsing EGPA, rituximab was not superior to azathioprine for improving the duration of total remission during 28 months while taking prednisone at 7.5 mg/d or less.
Study context
- Population
- Participants with newly diagnosed or relapsing eosinophilic granulomatosis with polyangiitis (EGPA) within 30 to 360 days of achieving vasculitis remission (Birmingham Vasculitis Activity Score of 0) after a standard induction regimenrandomized participants (mean age, 59.0 years [SD, 14.4], 50 women [51%]), all received at least 1 dose of the trial regimen and 92 (94%) completed the trial
- Participants
- 98 participants
- Comparison
- Rituximab vs azathioprine maintenance therapy
- RITUXIMABn = 49
- AZATHIOPRINEn = 49reference
- Primary endpoint
- Duration of total remission while taking 7.5 mg/d or less of prednisone (mean time in remission)
- Follow-up
- 28-month study period
Methodological details36 hospitals in France
- 36 hospitals in France
Primary result
As reported in the abstract
P = 0.38
Secondary outcomes
Proportion of participants who remained in remission with prednisone at 7.5 mg/d or less · 28-month study period
relative risk 1.51 (0.83–2.73) · P = 0.18
At least 1 vasculitis relapse
At least 1 clinically significant asthma exacerbation, rhinosinusitis exacerbation, or both
Safety
Severe infections
- Severe infections: primarily due to severe SARS-CoV-2 infections
Death
- One participant in the azathioprine group died of SARS-CoV-2 infection before vaccine development
Original publication
Rituximab vs Azathioprine for Eosinophilic Granulomatosis With Polyangiitis Maintenance Therapy: A Randomized Clinical Trial. JAMA. Published 22 October 2026. doi:10.
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