Page 9 - Read Online

Skopis et al. Vessel Plus 2020;4:30 I http://dx.doi.org/10.20517/2574-1209.2020.42 Page 5 of 14

Table 1. Studies regarding maintenance therapy with Rituximab in ANCA-associated vasculitis
Study and year of study Study design Objective of study Results Study limitations
Response of Wegner’s Case Report To describe the successful Rituximab was able The report only describes
granulomatosis to use of rituximab to to successfully induce the response of one
Anti-CD20 chimeric treat a patient with and maintain disease individual to rituximab
monoclonal antibody chronic, relapsing GPA remission in a patient which fails to generalize
therapy, 2001 [16] who did not tolerate with chronic, relapsing the results to other
cyclophosphamide GPA resistant to other patients with ANCA
therapy and was immunosuppressants associated vasculitis
resistant to treatment
with glucocorticoids,
azathioprine and
mycophenolate mofetil
Nine patients with anti- Case series which To review the outcomes Rituximab was efficient No control arm
neutrophil cytoplasmic included with structured of 9 patients with MPA and safe as an induction Possible selection bias
antibody-associated patient follow up and GPA treated with and maintenance therapy Patients received
vasculitis successfully rituximab who were for patients with MPA and additional
treated with rituximab, either resistant to or GPA immunosuppressive
2005 [17] had recurrent relapses medications while they
after cessation of were on treatment with
cyclophosphamide rituximab
Adjunction of rituximab Retrospective study To investigate rituximab Treatment of relapsing/ Patients were
to steroids and of 8 patients with use in conjunction with refractory GPA with receiving concomitant
immunosuppressants refractory or relapsing ongoing steroid and rituximab in conjunction immunosuppressive
for refractory/relapsing GPA who received immunosuppressant with steroids/ therapy so it is difficult
Wegner’s granulomatosis: rituximab infusions in therapy as a treatment immunosuppressants to tell if results could be
a study on 8 patients, addition to their ongoing for relapsing/refractory resulted in good clinical attributed to rituximab
2007 [18] immunosuppressive GPA and to determine the outcomes alone
therapy frequency of infusions, There was a dissociation
time to patient response in the time to response of
and, effects on the various vasculitis manifestations
manifestations of GPA (improved over days to
weeks) vs. granulomatous
manifestations (improved
over several months) to
rituximab
A multicenter survey of Standardized, To determine if rituximab Rituximab was found to be Possibility of positive
Rituximab therapy for retrospective data is a safe and effective successful as an induction outcome bias given
refractory antineutrophil collection from 65 patients option in treating patients therapy in patients with that the study was a
cytoplasmic antibody- at 4 centers in the UK with with ANCA associated AAV retrospective review
associated vasculitis, a history of refractory AAV vasculitis Additionally, patients
2009 [19] who received rituximab as who received preemptive
induction therapy (largest retreatment in the absence
series reported at that of any signs of a relapse
time) with a regimen of 1 g
rituximab every 6 months
had no disease relapse
at eleven- month follow
up, suggesting rituximab
as a viable maintenance
therapy
Rituximab as maintenance Retrospective review of To determine the efficacy Rituximab was safe and Comparison with other
therapy for anti- 39 patients with AAV who and safety of rituximab effective in maintaining studies is limited because
neutrophil cytoplasmic received maintenance infusions as maintenance disease remission in this cohort had lower
antibody-associated therapy with rituximab therapy in patients patients with ANCA- disease activity at study
vasculitis, 2010 [20] with ANCA-associated associated vasculitis onset
vasculitis who had
achieved complete or
partial remission
Rituximab for remission Single-center historical To determine the efficacy Rituximab was effective Open-label administration
induction and cohort study observing of rituximab as a therapy and well tolerated of rituximab
maintenance in refractory all patients (53 total) for maintenance of as an induction and Experience of study was
granulomatosis with with a history of chronic remission in patients maintenance therapy in only from one center
polyangiitis (Wegner’s), relapsing GPA treated with a history of chronic patients with a history of with a predominantly
2012: ten year experience with rituximab therapy relapsing refractory GPA chronic relapsing GPA Caucasian population
at a single center [21] from January 1, 2000 to of Scandinavian and
May 31, 2010 Northern European
background
Except for 1 patient, all
patients were PR-3 ANCA
positive