Title :

Rituximab resistance at 3 months of induction therapy in newly diagnosed or relapsing ANCA associated vasculitis: a French multicentre study.

Author(s) :

Machet, Thomas [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Quéméneur, Thomas [Auteur]
Centre hospitalier [Valenciennes, Nord]
Ledoult, Emmanuel [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Mesbah, Rafik [Auteur]
Centre Hospitalier Boulogne-sur-mer
Lebas, Céline [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Hachulla, Eric [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Pokeerbux, Mohammad Ryadh [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]

Journal title :

Joint Bone Spine

Abbreviated title :

Joint Bone Spine

Volume number :

90

Pages :

105591

Publication date :

2023-05-27

ISSN :

1778-7254

English keyword(s) :

Antineutrophil cytoplasm antibody
ANCA-associated vasculitis
Biological therapies
Rituximab
Uncontrolled disease
Disease flare

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objective To evaluate rituximab (RTX) resistance at 3 months (M3) of induction therapy in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Methods Multicentre French retrospective study conducted ...
Show more >Objective To evaluate rituximab (RTX) resistance at 3 months (M3) of induction therapy in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Methods Multicentre French retrospective study conducted between 2010 and 2020 including patients with newly diagnosed or relapsing AAV (granulomatosis with polyangiitis or microscopic polyangiitis) having received induction therapy with RTX. Primary endpoint was the presence of RTX resistance at 3 months (M3) defined as uncontrolled disease (worsening feature on the BVAS/WG 1 month after RTX induction) or disease flare (increase in BVAS/WG of ≥ 1 point before M3). Results Out of 121 patients included, we analysed 116 patients. Fourteen patients (12%) had RTX resistance at M3 with no difference in baseline demographics, vasculitis type, ANCA type, disease status or organ involvement. Patients with RTX resistance at M3 had a greater proportion of localized disease (43% vs. 18%, P < 0.05) and were less often treated by initial methylprednisolone (MP) pulse (21% vs. 58%, P < 0.01). Out of the 14 patients with RTX resistance, seven received additional immunosuppressive therapy. All patients were in remission at 6 months. Compared to responders, patients with RTX resistance at M3 were less often treated with prophylactic trimethoprim–sulfamethoxazole (57% vs. 85%, P < 0.05). Twenty-four patients died during follow-up, one-third of them from infections and half of them from SARS-CoV-2. Conclusion Twelve percent of patients had RTX resistance at M3. These patients more often had localized form of the disease and were less treated by initial MP pulse and by prophylactic trimethoprim–sulfamethoxazole.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T22:36:42Z
2024-01-31T08:43:36Z