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

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.

Authors

Institutions

Publication Details

Journal
Clinical Rheumatology
Published
2024-08-12
DOI
https://doi.org/10.1007/s10067-024-07096-y
Primary Topic
Vasculitis and related conditions
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

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

Naoho Takizawa, Ryo Nishioka, Yutaka Kawahito, Yuji Kukida et al.
Clinical Rheumatology
Vasculitis and related conditions
article

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

Naoho Takizawa, Ryo Nishioka, Yutaka Kawahito, Yuji Kukida, Toshiko Ito‐Ihara, Tomoaki Takata, Yasuhiro Shimojima, Genki Kidoguchi, Takashi Kawaguchi, Kunihiro Ichinose, Tohru Takeuchi, Takashi Kida, Yasuhiko Yamano, Satoshi Ōmura, Ryota Okazaki, Kiyoshi Matsui, Daiki Nakagomi, Naoya Kondo, Yoshia Miyawaki, Nobuyuki Yajima, Sho Mokuda, Tomohiro Sugimoto, Hirofumi Watanabe, Ryo Yanai, Yusuke Yoshida, Shintaro Hirata, Takuya Yanagida, Masaru Kato, Yoshiyuki Abe, Atsushi Nomura, Takafumi Ito, Koji Endo, Mayuko Moriyama, Ayuko Takatani, Masatoshi Kadoya, Yusuke Matsuo
article en

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.

Clinical RheumatologyVol. 43(10)
Kanazawa University (JP), SHOWA Medical University (JP), Tokyo Medical and Dental University (JP), Shinshu University (JP), Tokyo University of Pharmacy and Life Sciences (JP), Okayama University (JP), Shimane University (JP), Hokkaido University (JP), Kyoto University (JP), Juntendo University (JP), Kyoto Prefectural University of Medicine (JP), St. Luke's International Hospital (JP), Chubu Rosai Hospital (JP), Sasebo City General Hospital (JP), University of Yamanashi Hospital (JP), Kagoshima University Hospital (JP), Hiroshima University Hospital (JP), Kure Kyosai Hospital (JP), Tottori Prefectural Central Hospital (JP), University Hospital Kyoto Prefectural University of Medicine (JP), Teikyo University Chiba Medical Center (JP), Kyoto Katsura Hospital (JP), Japanese Red Cross Society Kyoto Daini Hospital (JP), Tosei General Hospital (JP), Nagasaki University (JP), Tottori University (JP), The University of Tokyo (JP), Hyogo University (JP), Osaka University of Pharmaceutical Sciences (JP)
Hiroshima University
Good health and well-being
Openalex Percentile: Top 76%
Vasculitis and related conditions
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.