PMID- 37784228
OWN - NLM
STAT- MEDLINE
DCOM- 20231204
LR  - 20231217
IS  - 1756-185X (Electronic)
IS  - 1756-1841 (Linking)
VI  - 26
IP  - 12
DP  - 2023 Dec
TI  - Rituximab induction and reinduction in granulomatosis with polyangiitis and 
      microscopic polyangiitis: A retrospective multicenter study in Taiwan.
PG  - 2441-2449
LID - 10.1111/1756-185X.14929 [doi]
AB  - OBJECTIVES: This study aimed to investigate the clinical outcomes of 
      granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) under 
      rituximab induction and reinduction therapy in Taiwan. METHODS: We performed a 
      retrospective study in patients with GPA or MPA receiving rituximab therapy from 
      August 2008 to July 2020 in seven medical centers in Taiwan. The clinical 
      characteristics and outcomes of these patients were analyzed. RESULTS: In total, 
      53 patients (18 with GPA and 35 with MPA) were included. Kidney involvement 
      (82.9% vs. 22.2%, p < .001) and initial creatinine (3.25 +/- 2.37 vs. 1.07 +/- 0.82, 
      p < .001) were significantly higher in MPA. Within 24 weeks after the first 
      course of rituximab, there were seven deaths (five due to infection and two due 
      to active disease) in patients with MPA (7/35, 20%) compared to 0 in patients 
      with GPA. Of 33 patients receiving rituximab for kidney involvement, 23 survived 
      and were free from renal replacement therapy at 24 weeks. Their chronic kidney 
      disease (CKD) stages improved in 2 but progressed in 7, while 24 had stable CKD 
      stages. Death or end-stage renal disease (ESRD) was associated with infection and 
      higher initial creatinine. Reinduction therapy for relapse was required in 18 
      (39.1%) of 46 survivors, which was associated with anti-proteinase 3 (PR3) 
      positive (odds ratio 3.667, p = .049) and younger age with a cutoff of 49.4 
      (AUC = 0.679, p = .030, sensitivity = 66.67%, specificity = 75%). CONCLUSION: 
      Significant mortality occurred after rituximab induction, especially in patients 
      with MPA. In survivors, age younger than 50 and anti-PR3 positive were associated 
      with the risk of relapse requiring reinduction.
CI  - (c) 2023 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons 
      Australia, Ltd.
FAU - Hsieh, Tsu-Yi
AU  - Hsieh TY
AD  - Division of Allergy, Immunology, and Rheumatology, Taichung Veterans General 
      Hospital, Taichung, Taiwan.
AD  - Department of Medical Education, Taichung Veterans General Hospital, Taichung, 
      Taiwan.
FAU - Chen, Ming-Han
AU  - Chen MH
AD  - Division of Allergy, Immunology, and Rheumatology, Taipei Veterans General 
      Hospital, Taipei, Taiwan.
AD  - Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
FAU - Wu, Chen-Ching
AU  - Wu CC
AD  - Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial 
      Hospital, Kaohsiung, Taiwan.
FAU - Hong, Wei-Jhe
AU  - Hong WJ
AD  - Division of Rheumatology and Immunology, Department of Internal Medicine, China 
      Medical University Hospital, Taichung, Taiwan.
FAU - Lu, Cheng-Hsun
AU  - Lu CH
AUID- ORCID: 0000-0002-4794-9438
AD  - Division of Rheumatology, Department of Internal Medicine, National Taiwan 
      University Hospital, Taipei, Taiwan.
FAU - Lu, Chun-Chi
AU  - Lu CC
AUID- ORCID: 0000-0001-6202-1382
AD  - Division of Rheumatology, Immunology, and Allergy, Department of Internal 
      Medicine, Tri-Service General Hospital, Taipei, Taiwan.
FAU - Lu, Ling-Ying
AU  - Lu LY
AD  - Division of Allergy, Immunology, and Rheumatology, Department of Medicine, 
      Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
FAU - Hsieh, Song-Chou
AU  - Hsieh SC
AD  - Division of Rheumatology, Department of Internal Medicine, National Taiwan 
      University Hospital, Taipei, Taiwan.
FAU - Tsai, Chang-Youh
AU  - Tsai CY
AD  - Division of Immunology and Rheumatology, Fu Jen Catholic University Hospital, New 
      Taipei City, Taiwan.
AD  - School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
FAU - Wu, Chien-Sheng
AU  - Wu CS
AUID- ORCID: 0000-0003-2815-1743
AD  - School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
AD  - Division of Allergy, Immunology, and Rheumatology, Far Eastern Memorial Hospital, 
      New Taipei City, Taiwan.
CN  - Taiwan Vasculitis Study Group
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20231002
PL  - England
TA  - Int J Rheum Dis
JT  - International journal of rheumatic diseases
JID - 101474930
RN  - 4F4X42SYQ6 (Rituximab)
RN  - AYI8EX34EU (Creatinine)
RN  - EC 3.4.21.76 (Myeloblastin)
SB  - IM
MH  - Humans
MH  - Rituximab/adverse effects
MH  - *Microscopic Polyangiitis/diagnosis/drug therapy
MH  - Retrospective Studies
MH  - *Granulomatosis with Polyangiitis/diagnosis/drug therapy/complications
MH  - Taiwan
MH  - Creatinine
MH  - Myeloblastin
MH  - *Kidney Failure, Chronic/therapy
MH  - Recurrence
OTO - NOTNLM
OT  - granulomatosis with polyangiitis
OT  - induction
OT  - microscopic polyangiitis
OT  - reinduction
OT  - rituximab
EDAT- 2023/10/03 06:47
MHDA- 2023/12/04 12:43
CRDT- 2023/10/03 00:13
PHST- 2023/09/12 00:00 [revised]
PHST- 2023/04/29 00:00 [received]
PHST- 2023/09/14 00:00 [accepted]
PHST- 2023/12/04 12:43 [medline]
PHST- 2023/10/03 06:47 [pubmed]
PHST- 2023/10/03 00:13 [entrez]
AID - 10.1111/1756-185X.14929 [doi]
PST - ppublish
SO  - Int J Rheum Dis. 2023 Dec;26(12):2441-2449. doi: 10.1111/1756-185X.14929. Epub 
      2023 Oct 2.