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10.1002/art.38788

http://scihub22266oqcxt.onion/10.1002/art.38788
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suck abstract from ncbi


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pmid25047592      Arthritis+Rheumatol 2014 ; 66 (11): 3151-9
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  • Rituximab for the Treatment of Relapses in ANCA-associated Vasculitis #MMPMID25047592
  • Miloslavsky E; Specks U; Merkel P; Seo P; Spiera R; Langford C; Hoffman G; Kallenberg C; St. Clair E; Tchao N; Viviano L; Ding L; Ikle D; Villarreal M; Jepson B; Brunetta P; Allen N; Fervenza F; Geetha D; Keogh K; Kissin E; Monach P; Peikert T; Stegeman C; Ytterberg S; Stone J
  • Arthritis Rheumatol 2014[Nov]; 66 (11): 3151-9 PMID25047592show ga
  • Introduction: Disease relapses are frequent in antineutrophil cytoplasmic antibody (ANCA)?associated vasculitis (AAV). We evaluated the outcomes of patients re-treated with rituximab (RTX) and prednisone for severe disease relapses. Methods: The Rituximab in AAV trial was a randomized, double-blind, placebo-controlled trial comparing the rates of remission induction among patients treated with RTX (n = 99) and patients treated with cyclophosphamide (CYC) followed by azathioprine (AZA) (n = 98). Prednisone was tapered to discontinuation after 5.5 months. After achieving remission, patients who experienced a severe disease relapse between months 6 and 18 were eligible to receive RTX and prednisone on an open-label basis according to a pre-specified protocol. Investigators remained blinded to the original treatment assignment. Results: Twenty-six patients received treatment with RTX for disease relapse after initially achieving remission on their originally assigned treatment. Fifteen patients were initially randomized to RTX and 11 to CYC/AZA. Thirteen (87%) of the patients originally assigned to RTX and 10 (91%) originally assigned to CYC/AZA achieved remission again with open-label RTX, an overall percentage of 88%. Half of the patients treated with open-label RTX were able to discontinue prednisone entirely. Patients in this cohort experienced fewer adverse events compared to the overall study population (4.7 adverse events/patient-year versus 11.8 adverse events/patient-year, respectively). Conclusion: Re-treatment of AAV relapses with RTX and glucocorticoids appears to be a safe and effective strategy, regardless of previous treatment.
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