Rituximab Alone Demonstrates Strong Remission Rates in ANCA-Associated Vasculitis Treatment, Study Finds
New research published in Clinical and Experimental Rheumatology indicates that rituximab monotherapy is a highly effective treatment option for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), performing comparably to, and in certain specific cases exceeding, more customary combination therapies.
AAV is a group of rare autoimmune diseases characterized by inflammation of small and medium-sized blood vessels.Rituximab,a medication that depletes B cells,is a cornerstone of AAV treatment,but optimal regimens for both inducing and maintaining remission have remained an area of ongoing inquiry.
Researchers at a German hospital retrospectively analyzed the clinical records of 166 AAV patients treated between 2010 and 2021. Patients received either glucocorticoids plus rituximab,glucocorticoids with rituximab combined with cyclophosphamide,or cyclophosphamide followed by azathioprine for maintenance. Of the 166 patients, 97 were diagnosed with granulomatosis with polyangiitis (GPA) and 69 with microscopic polyangiitis (MPA).
After 24 months, 35% of patients treated with rituximab alone achieved complete remission, a rate statistically similar to the 33% observed in those receiving rituximab plus cyclophosphamide.notably,only 9% of patients on cyclophosphamide and azathioprine achieved complete remission.
While overall remission rates – including partial remission - were high across all groups (88% in the rituximab group,87% in the rituximab + cyclophosphamide group,and 81% in the cyclophosphamide + azathioprine group),patients with GPA specifically demonstrated a lower risk of relapse when treated with rituximab monotherapy compared to the rituximab/cyclophosphamide combination.
“The present retrospective study suggests comparable efficacy of [glucocorticoids] in combination with [rituximab] alone and combined [rituximab/cyclophosphamide] therapy…and [cyclophosphamide/azathioprine] treatment for the induction and maintenance of remission over 24 months in patients with AAV,” the authors concluded.
