Long-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis
Authors: Pierre Charles, Loïc Guillevin
Journal: Annals of Internal Medicine (2020)

Letters1 December 2020Long-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody–Associated VasculitisPierre Charles, MD and Loïc Guillevin, MDPierre Charles, MDCochin Hospital, Université de Paris, and Institut Mutualiste Montsouris, Paris, France (P.C.)Search for more papers by this author and Loïc Guillevin, MDCochin Hospital, Université de Paris, Paris, France (L.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-1199 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with many of Dr. Jain and colleagues' comments. In MAINRITSAN3, the placebo group and patients with anti–proteinase-3 ANCAs had a high rate of relapse. However, the trial population as a whole had a relatively good prognosis. The results suggest that we should consider that AAVs, especially anti–proteinase-3 ANCAs, can be managed as chronic diseases and warrant long-term maintenance therapy with rituximab (for ≥4 years). How to administer this therapy is not easy to resolve. In MAINRITSAN2 (1), the cumulative rituximab dose was lower and the relapse rate only slightly higher thanks to a reinfusion algorithm based ...References1. Charles P, Terrier B, Perrodeau É, et al. Comparison of individually tailored versus fixed-schedule rituximab regimen to maintain ANCA-associated vasculitis remission: results of a multicentre, randomised controlled, phase III trial (MAINRITSAN2). Ann Rheum Dis. 2018;77:1143-9. [PMID: 29695500] CrossrefMedlineGoogle Scholar2. Charles P, Néel A, Tieulié N, et al. Rituximab for induction and maintenance treatment of ANCA-associated vasculitides: a multicentre retrospective study on 80 patients. Rheumatology (Oxford). 2014;53:532-9. [PMID: 24282319] CrossrefMedlineGoogle Scholar3. Guillevin L, Pagnoux C, Karras A, et al. Rituximab versus azathioprine for maintenance in ANCA-associated vasculitis. N Engl J Med. 2014;371:1771-80. [PMID: 25372085] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cochin Hospital, Université de Paris, and Institut Mutualiste Montsouris, Paris, France (P.C.)Cochin Hospital, Université de Paris, Paris, France (L.G.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3827. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLong-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Pierre Charles , Élodie Perrodeau , Maxime Samson , Bernard Bonnotte , Antoine Néel , Christian Agard , Antoine Huart , Alexandre Karras , François Lifermann , Pascal Godmer , Pascal Cohen , Catherine Hanrotel-Saliou , Nicolas Martin-Silva , Grégory Pugnet , François Maurier , Jean Sibilia , Pierre-Louis Carron , Pierre Gobert , Nadine Meaux-Ruault , Thomas Le Gallou , Stéphane Vinzio , Jean-François Viallard , Eric Hachulla , Christine Vinter , Xavier Puéchal , Benjamin Terrier , Philippe Ravaud , Luc Mouthon , Loïc Guillevin , and Long-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Thomas D. Garvey , Kenneth J. Warrington , and Matthew J. Koster Long-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Siddharth Jain , Arghya Chattopadhyay , and Aman Sharma Metrics Cited byThe use of ECMO in pediatric granulomatosis with polyangiitisANCA associated vasculitis (AAV): a review for internistsTreating Patients With ANCA-Associated Vasculitis and Very Severe Renal Injury With an Intensified B Cell Depletion Therapy: Comparison With a Control Cohort Receiving a Conventional TherapySubcutaneous Cheek Nodule Associated with Granulomatosis with Polyangiitis 1 December 2020Volume 173, Issue 11Page: 948KeywordsAdverse eventsAlgorithmsCellsDisclosureLymphocytesSerious adverse eventsVasculitis ePublished: 1 December 2020 Issue Published: 1 December 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...