TY - JOUR
T1 - Effectiveness and safety of rituximab in severely relapsed antineutrophil cytoplasmic antibody–associated vasculitis
T2 - a retrospective analysis of a Japanese multicentre cohort from the J-CANVAS
AU - on behalf of Japan Collaborative Registry of ANCA-Associated Vasculitis (J-CANVAS)
AU - Kidoguchi, Genki
AU - Yoshida, Yusuke
AU - Watanabe, Hirofumi
AU - Sugimoto, Tomohiro
AU - Mokuda, Sho
AU - Kida, Takashi
AU - Yajima, Nobuyuki
AU - Omura, Satoshi
AU - Nakagomi, Daiki
AU - Abe, Yoshiyuki
AU - Kadoya, Masatoshi
AU - Takizawa, Naoho
AU - Nomura, Atsushi
AU - Kukida, Yuji
AU - Kondo, Naoya
AU - Yamano, Yasuhiko
AU - Yanagida, Takuya
AU - Endo, Koji
AU - Matsui, Kiyoshi
AU - Takeuchi, Tohru
AU - Ichinose, Kunihiro
AU - Kato, Masaru
AU - Yanai, Ryo
AU - Matsuo, Yusuke
AU - Shimojima, Yasuhiro
AU - Nishioka, Ryo
AU - Okazaki, Ryota
AU - Takata, Tomoaki
AU - Ito, Takafumi
AU - Moriyama, Mayuko
AU - Takatani, Ayuko
AU - Miyawaki, Yoshia
AU - Ito-Ihara, Toshiko
AU - Kawaguchi, Takashi
AU - Kawahito, Yutaka
AU - Hirata, Shintaro
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/10
Y1 - 2024/10
N2 - 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.
AB - 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.
KW - ANCA-associated vasculitis
KW - Granulomatosis with polyangiitis
KW - Microscopic polyangiitis
KW - Relapse
KW - Rituximab
UR - http://www.scopus.com/inward/record.url?scp=85201557267&partnerID=8YFLogxK
U2 - 10.1007/s10067-024-07096-y
DO - 10.1007/s10067-024-07096-y
M3 - 学術論文
C2 - 39134873
AN - SCOPUS:85201557267
SN - 0770-3198
VL - 43
SP - 3195
EP - 3204
JO - Clinical Rheumatology
JF - Clinical Rheumatology
IS - 10
ER -