Effectiveness and safety of rituximab in severely relapsed antineutrophil cytoplasmic antibody–associated vasculitis: a retrospective analysis of a Japanese multicentre cohort from the J-CANVAS

on behalf of Japan Collaborative Registry of ANCA-Associated Vasculitis (J-CANVAS)

Research output: Contribution to journalArticlepeer-review

Abstract

We aimed to clarify the long-term safety and efficacy of rituximab (RTX) as a remission induction therapy following severe relapse in patients with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV). We retrospectively collected the data of patients with severely relapsed AAV from a Japanese multicentre cohort. The primary exposure was RTX use; the primary outcome was complete remission (CR) proportions at week 24. Baseline characteristics were compared between the RTX and non-RTX groups. We performed multivariate logistic regression analysis and one-to-one propensity score matching analysis as a sensitivity analysis. Totally, 100 patients were enrolled: 52 in the RTX group and 48 in the non-RTX group. Baseline characteristics were comparable between the two groups, except for age, AAV subtype and ANCA serotype. The median age was 71 vs. 75 years, and the PR3-ANCA positivity rate was 44.2% vs. 18.8% in the RTX and non-RTX groups, respectively. No significant difference was observed in CR proportions at week 24 between the two groups (79.2% vs. 68.1%, p = 0.321), with an adjusted odds ratio of 1.27 (95% confidence interval [CI] 0.47–3.51). At week 48, CR proportions were significantly higher in the RTX group (91.7% vs. 64.9%, p = 0.005), with an adjusted odds ratio of 2.95 (95% CI 0.97–9.91). Serious infection rates were lower in the RTX group than in the non-RTX group, with no statistically significant difference. RTX was not superior to conventional immunosuppressive therapies at week 24 but showed significantly favourable results at week 48 for severely relapsed AAV.

Original languageEnglish
Pages (from-to)3195-3204
Number of pages10
JournalClinical Rheumatology
Volume43
Issue number10
DOIs
StatePublished - 2024/10

Keywords

  • ANCA-associated vasculitis
  • Granulomatosis with polyangiitis
  • Microscopic polyangiitis
  • Relapse
  • Rituximab

ASJC Scopus subject areas

  • Rheumatology

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