Reducing the initial number of rituximab maintenance-therapy infusions for ANCA-associated vasculitides: randomized-trial post-hoc analysis.

Rheumatology
Pierre CharlesFrench Vasculitis Study Group

Abstract

The randomized, controlled MAINRITSAN2 trial was designed to compare the capacity of an individually tailored therapy [randomization day 0 (D0)], with reinfusion only when CD19+ lymphocytes or ANCA had reappeared, or if the latter's titre rose markedly, with that of five fixed-schedule 500-mg rituximab infusions [D0 + D14, then months (M) 6, 12 and 18] to maintain ANCA-associated vasculitis (AAV) remissions. Relapse rates did not differ at M28. This ancillary study was undertaken to evaluate the effect of omitting the D14 rituximab infusion on AAV relapse rates at M12. MAINRITSAN2 trial data were subjected to post-hoc analyses of M3, M6, M9 and M12 relapse-free survival rates in each arm as primary end points. Exploratory subgroup analyses were run according to CYC or rituximab induction and newly diagnosed or relapsing AAV. At M3, M6, M9 and M12, respectively, among the 161 patients included, 79/80 (98.8%), 76/80 (95%), 74/80 (92.5%) and 73/80 (91.3%) from D0, and 80/81 (98.8%), 78/81 (96.3%), 76/81 (93.8%) and 76/81 (93.8%) from D0+D14 groups were alive and relapse-free. No between-group differences were observed. Results were not affected by CYC or rituximab induction, or newly diagnosed or relapsing AAV. We were not able to...Continue Reading

References

Jul 22, 2010·The New England Journal of Medicine·Rachel B JonesUNKNOWN European Vasculitis Study Group
Jul 22, 2010·The New England Journal of Medicine·John H StoneUNKNOWN RAVE-ITN Research Group
Mar 15, 2014·Clinical Journal of the American Society of Nephrology : CJASN·William F PendergraftJohn L Niles
Nov 6, 2014·The New England Journal of Medicine·Loïc GuillevinUNKNOWN French Vasculitis Study Group

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Citations

Nov 14, 2020·Current Opinion in Nephrology and Hypertension·Yutian LeiHans-Joachim Anders

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