The Role of Extended rituximab maintenance therapy for patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (Aug. 2020)

The impact of "Cigarette smoking" on increasing the risk of ANCA-associated vasculitis (July 2020)

The inhaled environmental exposure materials may enhance the risk of anti-neutrophil cytoplasmic auto-AB (ANCA)-associated vasculitis development. In a large, case-control report that conducted > 450 ptns with ANCA-associated vasculitis (65 % have showed myeloperoxidase [MPO]-ANCA +ve) and > 1400 matched controls found that cigarette smoking was accompanied with an augmented odds of having ANCA-associated vasculitis as compared to nonsmoker subjects. This association was particularly robust among ptns who were MPO-ANCA +ve. Furthermore, there was a dose-dependent relationship between the cumulative smoking period and risk of ANCA-associated vasculitis. Additional studies, however, may be warranted to confirm these finding and to investigate the potential underlying pathogenetic mechanisms.  

 

McDermott G, Fu X, Stone JH, et al. Association of Cigarette Smoking With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis. JAMA Intern Med 2020; 180:870.

The Role of Extended rituximab maintenance therapy for patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (Aug. 2020)

 

In ptns with granulomatosis and polyangiitis (GPA) or with microscopic polyangiitis (MPA), the recommended optimal duration of therapy to maintain remission still uncertain. In order to evaluate the efficacy of extended rituximab (Rtx) therapy to prevent the relapse incidence in ptns with GPA or MPA, 97 ptns who had achieved remission after the institution of induction therapy and an initial 18 mo Rtx maintenance protocol were randomly assigned to receive either an extended 18 mo protocol of Rtx or placebo. At 28 mo, ptns in the extended Rtx group showed a lower incidence of relapse as compared to the placebo g. (4 vs 26 %); no deaths occurred, and rates of adverse events were similar in both groups. Analysis of these findings may support the use of extended maintenance therapy in ptns who commenced Rtx therapy.  

Charles P, Perrodeau É, Samson M, et al. Long-Term Rituximab Use to Maintain Remission of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A Randomized Trial. Ann Intern Med 2020; 173:179.