Current therapy of granulomatosis with polyangiitis and microscopic polyangiitis: the role of rituximab

Duvuru Geetha, Cees Kallenberg, John H. Stone, Alan D. Salama, Gerald B. Appel, George Duna, Paul Brunetta, David Jayne

Research output: Contribution to journalReview article

Abstract

Granulomatosis with polyangiitis and microscopic polyangiitis are anti-neutrophil cytoplasmic antibody-associated vasculitides (AAVs) that are prone to cycles of remission and relapse. The introduction of cytotoxic therapy has changed the prognosis for these diseases from typically fatal to manageable chronic illnesses with a relapsing course. Despite improvements in outcomes, recurrence of disease and drug-related toxicity continue to produce significant morbidity and mortality. Better understanding of the pathogenesis of AAV and the mechanism of action of cyclophosphamide has led to investigation of therapies that target B cells. Two randomized controlled trials have shown that rituximab is not inferior to cyclophosphamide for induction of remission in severe AAV, with no significant difference in the incidence of overall adverse events in rituximab- versus cyclophosphamide-treated patients. Data from ongoing clinical trials will determine the role of rituximab in the maintenance of remission.

Original languageEnglish (US)
Pages (from-to)17-27
Number of pages11
JournalJournal of Nephrology
Volume28
Issue number1
DOIs
StatePublished - 2014

Keywords

  • Anti-neutrophil cytoplasmic antibody
  • Renal
  • Rituximab
  • Vasculitis

ASJC Scopus subject areas

  • Nephrology

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    Geetha, D., Kallenberg, C., Stone, J. H., Salama, A. D., Appel, G. B., Duna, G., Brunetta, P., & Jayne, D. (2014). Current therapy of granulomatosis with polyangiitis and microscopic polyangiitis: the role of rituximab. Journal of Nephrology, 28(1), 17-27. https://doi.org/10.1007/s40620-014-0135-3