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Original ArticlesClinical Nephrology
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Rituximab as Maintenance Therapy for Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis

Eugene P. Rhee, Karen A. Laliberte and John L. Niles
CJASN August 2010, 5 (8) 1394-1400; DOI: https://doi.org/10.2215/CJN.08821209
Eugene P. Rhee
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Karen A. Laliberte
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John L. Niles
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    Figure 1.

    Median BVAS/WG with rituximab treatment. Box plot shows upper and lower quartiles; whiskers show maximum values. *P < 0.05 compared with time 0.

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    Figure 2.

    Mean ANCA titers (log-transformed) with rituximab treatment. Error bars show SEM. *P < 0.05 compared with time 0.

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    Figure 3.

    Median medication doses with rituximab treatment. Box plot shows upper and lower quartiles; whiskers show maximum and minimum values. *P < 0.05 compared with time 0.

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    Table 1.

    Baseline characteristics of the study sample

    CharacteristicsComplete Remission at Rituximab InitiationPartial Remission at Rituximab InitiationCombined
    Number172239
    Number with anti-PR3/anti-MPO11/613/924/15
    Median age (range)63 (25 to 87)59.5 (39 to 88)60 (25 to 88)
    Women (percent)6 (35%)14 (64%)20 (51%)
    Median BVAS/WG at AAV diagnosis (range)5 (1 to 8)4.5 (1 to 9)5 (1 to 9)
    Median BVAS/WG at rituximab initiation (range)0 (NA)2 (1 to 4)1 (1 to 4)
    Median duration before rituximab, months (range)51 (3 to 282)71.5 (3 to 506)67 (3 to 506)
    Number of relapses at rituximab initiation
        08513
        1 to 271118
        >2268
    12 months of follow-up available11819
    24 months of follow-up available61420
    • NA, not applicable.

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    Table 2.

    Indications for initiation of rituximab

    IndicationsComplete Remission at Rituximab Initiation (n = 17)Partial Remission at Rituximab Initiation (n = 22)Combined
    Persistent symptoms attributable to AAV088
    Cyclophosphamide dependence (with or without symptoms)448
    Bone marrow toxicity235
    Steroid toxicity (e.g., weight gain, diabetes, avascular necrosis, osteoporotic fracture)6511
    Rising or persistently high ANCA41014
    Othera224
    • ↵a Other includes severe fatigue (n = 2), patient desire to wean oral immunosuppression (n = 1), and bacterial pneumonia on cyclophosphamide and prednisone (n = 1).

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Clinical Journal of the American Society of Nephrology
Vol. 5, Issue 8
1 Aug 2010
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Rituximab as Maintenance Therapy for Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Eugene P. Rhee, Karen A. Laliberte, John L. Niles
CJASN Aug 2010, 5 (8) 1394-1400; DOI: 10.2215/CJN.08821209

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Rituximab as Maintenance Therapy for Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Eugene P. Rhee, Karen A. Laliberte, John L. Niles
CJASN Aug 2010, 5 (8) 1394-1400; DOI: 10.2215/CJN.08821209
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Cited By...

  • The Search for a Biomarker of Relapse in ANCA-Associated Vasculitis
  • Repeat cycles of rituximab on clinical relapse in ANCA-associated vasculitis: identifying B cell biomarkers for relapse to guide retreatment decisions
  • Long-Term Maintenance Therapy Using Rituximab-Induced Continuous B-Cell Depletion in Patients with ANCA Vasculitis
  • Could we abandon cyclophosphamide in systemic vasculitis and lupus nephritis?
  • Documentation of off-label use of biologics in Rheumatoid Arthritis
  • Decreased CD5+ B Cells in Active ANCA Vasculitis and Relapse after Rituximab
  • Long-Term Remissions of Severe Pemphigus After Rituximab Therapy Are Associated with Prolonged Failure of Desmoglein B Cell Response
  • Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2011
  • Efficacy of rituximab in primary Sjogren's syndrome with peripheral nervous system involvement: results from the AIR registry
  • Rituximab Maintenance Therapy for Granulomatosis with Polyangiitis and Microscopic Polyangiitis
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