Biothérapies et anticorps monoclonaux

Seror, R.; Pagnoux, Ch.

doi:10.1016/b978-2-294-71107-7.50059-7

Cited by 1 publication

(2 citation statements)

References 81 publications

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“…Among patients failing induction therapy with IV CYC, 20 were switched to oral CYC and 15 (75%) responded favorably (combined with infliximab in 1 patient). 199 Hence, oral CYC may be effective as "rescue" therapy for patients failing IV pulse CYC, but we believe RTX is superior in this context.…”

Section: Treatmentmentioning

confidence: 92%

“…A prospective study by French investigators (WEGENT trial) treated 159 patients with newly diagnosed AAV and one or more unfavorable prognostic factor with IV CYC plus CS as initial induction therapy. 199 CRs were achieved in 126 (79.2%); one stopped therapy (allergy); 32 were refractory (GPA n ¼ 24; MPA, n ¼ 8). Eleven patients died early (median: 2.5 months), either of uncontrolled disease, infections, or both.…”

Section: Treatmentmentioning

confidence: 99%

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Granulomatosis with Polyangiitis (Wegener's Granulomatosis): Evolving Concepts in Treatment

Lynch

Derhovanessian

Tazelaar

et al. 2018

Semin Respir Crit Care Med

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Granulomatosis with polyangiitis (GPA), formerly termed Wegener's granulomatosis, is the most common of the pulmonary vasculitides. GPA typically involves the upper respiratory tract, lower respiratory tract (bronchi and lung), and kidney, with varying degrees of disseminated vasculitis. Cardinal histologic features include a necrotizing vasculitis involving small vessels, extensive “geographic” necrosis, and granulomatous inflammation. The spectrum and severity of the disease is heterogeneous, ranging from indolent disease involving only one site to fulminant, multiorgan vasculitis. Circulating antibodies against cytoplasmic components of neutrophils (ANCAs) play a role in the pathogenesis, and often correlate with activity of the disease. Treatment strategies are evolving. Cyclophosphamide (CYC) plus corticosteroids was the mainstay of therapy for generalized, multisystemic GPA since the 1970s. However, within the past decade, rituximab (RTX), a monoclonal antibody directed against B cells, has been shown to be at least as effective (and possibly more effective) as CYC. Furthermore, the use of RTX may reduce the need for maintenance immunosuppression. Optimal therapy for GPA remains controversial, and additional studies are required to determine the role and duration of maintenance therapy following successful induction therapy.

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Section: Treatmentmentioning

confidence: 92%

Section: Treatmentmentioning

confidence: 99%