PMID- 25047592
OWN - NLM
STAT- MEDLINE
DCOM- 20150210
LR  - 20240321
IS  - 2326-5205 (Electronic)
IS  - 2326-5191 (Print)
IS  - 2326-5191 (Linking)
VI  - 66
IP  - 11
DP  - 2014 Nov
TI  - Rituximab for the treatment of relapses in antineutrophil cytoplasmic 
      antibody-associated vasculitis.
PG  - 3151-9
LID - 10.1002/art.38788 [doi]
AB  - OBJECTIVE: Disease relapses are frequent in antineutrophil cytoplasmic 
      antibody-associated vasculitis (AAV). This study was undertaken to evaluate 
      outcomes in patients with AAV who are re-treated with rituximab (RTX) and 
      prednisone for severe disease relapses. METHODS: The Rituximab in AAV trial was a 
      randomized, double-blind, placebo-controlled trial comparing the rates of 
      remission induction among patients treated with RTX (n = 99) and patients treated 
      with cyclophosphamide (CYC) followed by azathioprine (AZA) (n = 98). Prednisone 
      was tapered to discontinuation after 5.5 months. After remission was achieved, 
      patients who experienced a severe disease relapse between months 6 and 18 were 
      eligible to receive RTX and prednisone on an open-label basis according to a 
      prespecified protocol. Investigators remained blinded with regard to the original 
      treatment assignment. RESULTS: Twenty-six patients received RTX for disease 
      relapse after remission had initially been achieved with their originally 
      assigned treatment. Fifteen of these patients were initially randomized to 
      receive RTX and 11 to receive CYC/AZA. Thirteen (87%) of the patients originally 
      assigned to receive RTX and 10 (91%) originally assigned to receive CYC/AZA 
      achieved remission again with open-label RTX (an overall percentage of 88%). In 
      half of the patients treated with open-label RTX, prednisone could be 
      discontinued entirely. Patients in this cohort experienced fewer adverse events 
      compared to the overall study population (4.7 adverse events per patient-year 
      versus 11.8 adverse events per patient-year). CONCLUSION: Re-treatment of AAV 
      relapses with RTX and glucocorticoids appears to be a safe and effective 
      strategy, regardless of previous treatment.
CI  - Copyright (c) 2014 by the American College of Rheumatology.
FAU - Miloslavsky, E M
AU  - Miloslavsky EM
AD  - Massachusetts General Hospital, Boston.
FAU - Specks, U
AU  - Specks U
FAU - Merkel, P A
AU  - Merkel PA
FAU - Seo, P
AU  - Seo P
FAU - Spiera, R
AU  - Spiera R
FAU - Langford, C A
AU  - Langford CA
FAU - Hoffman, G S
AU  - Hoffman GS
FAU - Kallenberg, C G M
AU  - Kallenberg CG
FAU - St Clair, E W
AU  - St Clair EW
FAU - Tchao, N K
AU  - Tchao NK
FAU - Viviano, L
AU  - Viviano L
FAU - Ding, L
AU  - Ding L
FAU - Ikle, D
AU  - Ikle D
FAU - Villarreal, M
AU  - Villarreal M
FAU - Jepson, B
AU  - Jepson B
FAU - Brunetta, P
AU  - Brunetta P
FAU - Allen, N B
AU  - Allen NB
FAU - Fervenza, F C
AU  - Fervenza FC
FAU - Geetha, D
AU  - Geetha D
FAU - Keogh, K
AU  - Keogh K
FAU - Kissin, E Y
AU  - Kissin EY
FAU - Monach, P A
AU  - Monach PA
FAU - Peikert, T
AU  - Peikert T
FAU - Stegeman, C
AU  - Stegeman C
FAU - Ytterberg, S R
AU  - Ytterberg SR
FAU - Stone, J H
AU  - Stone JH
CN  - Rituximab in ANCA-Associated Vasculitis-Immune Tolerance Network Research Group
LA  - eng
SI  - ClinicalTrials.gov/NCT00104299
GR  - UL1-RR-025771/RR/NCRR NIH HHS/United States
GR  - UL1 RR025005/RR/NCRR NIH HHS/United States
GR  - N01 AI015416/AI/NIAID NIH HHS/United States
GR  - K23 AR052820/AR/NIAMS NIH HHS/United States
GR  - M01 RR000533/RR/NCRR NIH HHS/United States
GR  - UL1 RR025771/RR/NCRR NIH HHS/United States
GR  - K24 AR002224/AR/NIAMS NIH HHS/United States
GR  - M01-RR-00533/RR/NCRR NIH HHS/United States
GR  - K24 AR049185/AR/NIAMS NIH HHS/United States
GR  - UL1 RR024150/RR/NCRR NIH HHS/United States
GR  - K23-AR-052820/AR/NIAMS NIH HHS/United States
GR  - N01AI15416/AI/NIAID NIH HHS/United States
GR  - 1 UL1-RR-024150-01/RR/NCRR NIH HHS/United States
GR  - K24-AR-049185/AR/NIAMS NIH HHS/United States
GR  - K24-AR-02224/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Arthritis Rheumatol
JT  - Arthritis & rheumatology (Hoboken, N.J.)
JID - 101623795
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Glucocorticoids)
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 8N3DW7272P (Cyclophosphamide)
RN  - MRK240IY2L (Azathioprine)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/*drug 
      therapy/*prevention & control
MH  - Antibodies, Monoclonal, Murine-Derived/*therapeutic use
MH  - Antirheumatic Agents/*therapeutic use
MH  - Azathioprine/therapeutic use
MH  - Cyclophosphamide/therapeutic use
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Glucocorticoids/therapeutic use
MH  - Humans
MH  - Prednisone/therapeutic use
MH  - Prospective Studies
MH  - Recurrence
MH  - Remission Induction/methods
MH  - Rituximab
MH  - Secondary Prevention/*methods
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC4229846
MID - NIHMS630196
EDAT- 2014/07/23 06:00
MHDA- 2015/02/11 06:00
PMCR- 2015/11/01
CRDT- 2014/07/23 06:00
PHST- 2014/01/27 00:00 [received]
PHST- 2014/07/15 00:00 [accepted]
PHST- 2014/07/23 06:00 [entrez]
PHST- 2014/07/23 06:00 [pubmed]
PHST- 2015/02/11 06:00 [medline]
PHST- 2015/11/01 00:00 [pmc-release]
AID - 10.1002/art.38788 [doi]
PST - ppublish
SO  - Arthritis Rheumatol. 2014 Nov;66(11):3151-9. doi: 10.1002/art.38788.