Off-Trial Evaluation of the B cell-Targeting Treatment in the Refractory Cases of Antineutrophil Cytoplasmic Antibodies (ANCA)-Associated Vasculitis: Long-Term Follow-Up from a Single Centre
| Autor: | Rille Pullerits, J. Vikgren, M. Ljevak, Maria Bokarewa |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Kidney business.industry Immunology Birmingham Vasculitis Activity Score General Medicine Disease medicine.disease Gastroenterology Surgery medicine.anatomical_structure Refractory Internal medicine medicine Rituximab Vasculitis business B cell Anti-neutrophil cytoplasmic antibody medicine.drug |
| Zdroj: | Scandinavian Journal of Immunology. 76:411-420 |
| ISSN: | 0300-9475 |
| DOI: | 10.1111/j.1365-3083.2012.02747.x |
| Popis: | The aim of the study was to evaluate long-term clinical and immunological effects of anti-B cell treatment in patients with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis refractory to conventional immunosuppressive treatment. Rituximab (RTX) was added to the ongoing immunosuppressive treatment in 29 patients with refractory ANCA-associated vasculitis. The disease activity was measured using Birmingham Vasculitis Activity Score/Wegener’s granulomatosis (BVAS/WG score), and clinical laboratory variables were recorded. The median BVAS/WG score before treatment was 6 (IQR 3–8), and 28 patients (97%) had disease flare classified either severe (62%) or limited (34%). Six of 29 patients (21%) achieved a complete remission, and 12 (41%) had a treatment response with ≥50% decrease in BVAS/WG score at 6 months. Fourteen patients (64%) with kidney involvement achieved remission, and in seven patients (50%), no flare was seen during the follow-up period. Three patients had renal flare and were successfully re-treated with RTX. Seventeen patients had disease symptoms from airways and eyes at RTX initiation, whereas only 29% displayed ≥50% treatment response. Limited clinical improvement was seen in patients with endobronchial lesions and trachea-subglottic granulomatous disease. RTX is a potent therapeutic option for ANCA-associated vasculitis refractory to conventional treatment. Best response may be expected in patients with vasculitic manifestations. |
| Databáze: | OpenAIRE |
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