Rituximab for remission induction in elderly patients with ANCA-associated vasculitis

Seminars in Arthritis and Rheumatism
H TimlinDuvura Geetha

Abstract

Advancing age is a risk factor for treatment-related side effects and mortality in AAV patients treated with cyclophosphamide (CYC) and glucocorticoids (GC) for remission induction. The efficacy and safety of rituximab (RTX) in elderly AAV patients has not been well described. We performed a single center retrospective review of 31 consecutive AAV patients aged 60 or more at the time of RTX use for remission induction. All patients received RTX with GC for remission induction. Four patients received concomitant CYC for a mean duration of 52 days. We evaluated clinical and laboratory variables at diagnosis, rates of complete remission defined as Birmingham Vasculitis Activity Score/Wegener's Granulomatosis (BVAS/WG) = 0 and patient survival, renal survival, infections requiring hospitalization, and vasculitis relapse 24 months following RTX use. Of the 31 patients, 77% were Caucasian, 68% female, mean age was 71 ± 6 years, 58% were MPO ANCA positive, and 42% had relapsing disease. The mean BVAS/WG score entry was 4.4 ± 1.5, 71% had glomerulonephritis (GN) and 10% had alveolar hemorrhage. The mean baseline e-GFR was 40 ± 28ml/min/1.73m(2). Thirty patients achieved remission with a mean time to remission of 57 ± 27 days. The singl...Continue Reading

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Citations

Aug 16, 2015·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Sari IwasakiAkihiro Ishizu
Feb 27, 2018·Blood Purification·Zdenka Hruskova, Vladimir Tesar
Jun 24, 2015·Clinical Journal of the American Society of Nephrology : CJASN·J Ashley Jefferson
Aug 23, 2019·Der Internist·C SchroederS von Vietinghoff
Aug 8, 2020·Clinical and Experimental Nephrology·Shinya TaguchiShuzo Kobayashi
Dec 7, 2018·The International Journal of Lower Extremity Wounds·Eran ShavitR Gary Sibbald
Nov 26, 2019·Expert Review of Clinical Immunology·Alvise Berti, Ulrich Specks
Nov 13, 2019·Néphrologie & thérapeutique·Aghilès HamrounFrançois Glowacki
Jun 12, 2021·Zeitschrift für Gerontologie und Geriatrie·Anne FerringAnna Maria Meyer

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