Rituximab in ANCA-Associated Vasculitis

Hassan, Romina; Gaffo, Angelo L.

doi:10.1007/s11926-017-0632-1

Cited by 47 publications

(32 citation statements)

References 29 publications

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“…The pathogenesis of GPA has been matter of intense debate in the past years, and it is not yet fully understood. The pathogenic role of ANCAs in GPA is supported by several instances of clinical evidence, which include a strong association with the disease (more than 90% of GPA patients display PR3‐ANCA positivity), the correlation of their titer with disease activity, and also the observation that targeted therapies reducing autoantibodies or depleting B cells, represent an effective treatment option for GPA . PR3‐ANCAs are able to induce neutrophil activation, and this generates a respiratory burst with the production of toxic oxygen radicals, release of destructive enzymes, and endothelial damage.…”

mentioning

confidence: 97%

Th17 and Treg lymphocytes as cellular biomarkers of disease activity in Granulomatosis with Polyangiitis

Cosmi

2017

Eur J Immunol

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mentioning

confidence: 97%

Th17 and Treg lymphocytes as cellular biomarkers of disease activity in Granulomatosis with Polyangiitis

Cosmi

2017

Eur J Immunol

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“…Trials of alternative therapies have not been conducted. In ANCA-associated vasculitis, rituximab appears to be non-inferior to cyclophosphamide in regard to induction of remission and superior when used for relapsing disease 16. Our patient underwent induction and sustained remission at 6 months using rituximab.…”

Section: Discussionmentioning

confidence: 79%

Prostatitis, a rare presentation of granulomatosis with polyangiitis, successfully treated with rituximab and prednisone

et al. 2018

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A previously healthy 21-year-old man presented with an 8-month history of weight loss, lethargy and dysuria unresponsive to empiric antibiotics and paraurethral drainage of a prostatic abscess. Urinalysis showed pyuria, but cultures failed to grow any organisms. Additionally, he developed new onset sensorineural hearing loss. CT of the chest showed two right-sided cavitary lesions. CT of the abdomen and pelvis demonstrated a prostatic abscess. A prostate biopsy demonstrated necrotising granulomatous prostatitis. A lung biopsy showed necrotising granulomatous inflammation. He was diagnosed with granulomatosis with polyangiitis (GPA). He was successfully treated with rituximab and prednisone. At 6-month follow-up, he continued to be in remission with resolution of his symptoms. This case demonstrates a rare presentation of prostatitis as the presenting symptom of GPA. As far as we know, this case is the first documented report of rituximab and prednisone as successful therapy for prostatitis secondary to GPA.

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“…RTX seems to be better than azathioprine in maintaining remission, as reported by MAINRITSAN trial and evidence-based medicine, suggesting the use of RTX for remission maintenance when combined with low-dose glucocorticoids for 24 months following remission induction. However, the best maintenance schedule and therapeutic duration remain to be defined 25 . In some patients, AAV appears to behave as a chronic and relapsing disease, requiring continued maintenance regimens.…”

Section: Discussionmentioning

confidence: 99%

Rituximab use in adult glomerulopathies and its rationale

et al. 2020

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Glomerulopathies are one of the leading causes of end-stage renal disease. In the last years, clinical research has made significant contributions to the understanding of such conditions. Recently, rituximab (RTX) has appeared as a reasonably safe treatment. The Kidney Disease: Improving Global Outcomes guidelines (KDIGO) recommended RTX only as initial treatment in antineutrophil cytoplasm antibody associated vasculitis (AAV) and in non-responders patients with lupus nephritis (LN), but these guidelines have not been updated since 2012. Nowadays, RTX seems to be at least as effective as other immunosuppressive regimens in idiopathic membranous nephropathy (IMN). In minimal-change disease, (MCD) this drug might allow a long-lasting remission period in steroid-dependent or frequently relapsing patients. Preliminary results support the use of RTX in patients with pure membranous LN and immunoglobulin-mediated membranoproliferative glomerulonephritis (MPGN), but not in patients with class III/IV LN or complement-mediated MPGN. No conclusion can be drawn in idiopathic focal segmental glomerulosclerosis (FSGS) and anti-glomerular basement membrane antibody glomerulonephritis (anti-GBM GN) because studies are small, heterogeneous, and scarce. Lastly, immunosuppression including RTX is not particularly useful in IgA nephropathy. This review presents the general background, outcomes, and safety for RTX treatment in different glomerulopathies. In this regard, we describe randomized controlled trials (RCTs) performed in adults, whenever possible. A literature search was performed using clinicaltrials.gov and PubMed.

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Rituximab in ANCA-Associated Vasculitis

Cited by 47 publications

References 29 publications

Th17 and Treg lymphocytes as cellular biomarkers of disease activity in Granulomatosis with Polyangiitis

Th17 and Treg lymphocytes as cellular biomarkers of disease activity in Granulomatosis with Polyangiitis

Prostatitis, a rare presentation of granulomatosis with polyangiitis, successfully treated with rituximab and prednisone

Rituximab use in adult glomerulopathies and its rationale

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