Rituximab maintenance therapy for patients with antineutrophil cytoplasmic antibody-associated vasculitis in Japan

Yukiko Takeyama, Nobuyuki Ono, Yuri Shirahama, Yasushi Inoue, Atsushi Tanaka, Naoyasu Ueda, Naoya Nishimura, Shuji Nagano, Ayumi Uchino, Tomoya Miyamura, Kensuke Oryoji, Hisako Inoue, Akihito Maruyama, Shun ichiro Ota, Seiji Yoshizawa, Takuya Sawabe, Naoko Himuro, Katsuhisa Miyake, Yasutaka Kimoto, Takahiko HoriuchiHiroki Mitoma, Hiroaki Niiro, Ayako Takamori, Yoshifumi Tada

Research output: Contribution to journalArticle

Abstract

Objectives: We examined the efficacy and safety of rituximab (RTX) maintenance therapy for patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in Japan. Methods: We conducted a retrospective study using a multi-center cohort database of vasculitis patients. All maintenance treatment courses were divided into three groups: a RTX group, a group treated with other immunosuppressant drugs (IS) and a group receiving glucocorticoid monotherapy (GC). The primary endpoint was the comparison of relapse-free survival after 1 year. We also analyzed the occurrence of severe adverse events (SAEs) to assess safety. Results: We included 123 courses of 107 patients (RTX n = 14, IS n = 64, GC n = 45). Twelve of 14 in the RTX group patients were diagnosed with granulomatosis with polyangiitis (GPA). The relapse-free survival of RTX maintenance therapy was comparable to that in the other groups (p =.122). After 1 year of treatment, the RTX group was administered lower steroid doses and one-third of them could withdraw corticosteroid. The overall incidence of SAE was 0.54/patient-year in the RTX group, 0.39/patient-year in the IS group and 0.34/patient-year in the GC group. Conclusion: RTX maintenance therapy could be effective and safe in Japanese GPA patients.

Original languageEnglish
JournalModern Rheumatology
DOIs
Publication statusAccepted/In press - 2020

All Science Journal Classification (ASJC) codes

  • Rheumatology

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    Takeyama, Y., Ono, N., Shirahama, Y., Inoue, Y., Tanaka, A., Ueda, N., Nishimura, N., Nagano, S., Uchino, A., Miyamura, T., Oryoji, K., Inoue, H., Maruyama, A., Ota, S. I., Yoshizawa, S., Sawabe, T., Himuro, N., Miyake, K., Kimoto, Y., ... Tada, Y. (Accepted/In press). Rituximab maintenance therapy for patients with antineutrophil cytoplasmic antibody-associated vasculitis in Japan. Modern Rheumatology. https://doi.org/10.1080/14397595.2020.1790778