Is Rituximab the Key to Preventing Relapse in ANCA Vasculitis?

According to a story from Renal & Neurology News, a recent study has found that rituximab is superior to azathioprine therapy in preventing symptoms relapse in patients living with ANCA vasculitis, a rare inflammatory disease. The results of this study could have major implications for the future treatment of patients who have experienced symptom relapse. The findings were first presented at the virtual European Renal Association-European Dialysis and Transplant Association 2020 congress.

About ANCA Vasculitis

ANCA vasculitis is a disease that is characterized by the damage and destruction of blood vessels as a result of inflammatory activity. The disease is associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA). These are autoantibodies that target antigens present on neutrophils (the most common type of white blood cell) and monocytes. This means that the mechanism of the disease is autoimmune, in which the body’s own immune system mistakenly attacks healthy body tissue. Symptoms of ANCA vasculitis include kidney inflammation, fever, weight loss, abdominal pain, bloody stools, purpura, nose bleeds, muscle pain, arthritis, bloody cough, vision problems, headaches, stroke, heart attack, and high blood pressure. Treatment of the disease is primarily focused on controlling inflammation and suppressing immune system activity. Common medications include cyclophosphamide, rituximab, and prednisone. Antibiotics may be necessary in cases of infection. To learn more about ANCA vasculitis, click here.

About The Trial

The clinical trial compared the effectiveness of rituximab versus azathioprine in 170 patients who had experienced relapse. The median age of the patient group was 59 years and the median disease duration was 5.3 years. Rituximab was able to reduce the risk of future relapse by 70 percent.

Patients were dosed with 1000mg of rituximab every four months and azathioprine was administered at 2 mg/kg per day. 13 percent of patients getting rituximab saw relapse compared to 38 percent of azathioprine patients. Azathioprine patients were more likely to experience severe relapses as well.

The results appear to indicate that rituximab, not azathioprine, should be the standard method of treatment for relapse prevention in ANCA vasculitis patients, at least in those patients that have already experienced their first relapse. Study investigator Dr. Rona M. Smith had this to say:

“The study results clearly showed the superiority of [rituximab] over azathioprine during the treatment period, without our finding any evidence that the substance has a worse profile—on the contrary.”


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