Title :

Long-term efficacy of remission-maintenance regimens for ANCA-associated vasculitides.

Author(s) :

Terrier, Benjamin [Auteur]
Pagnoux, Christian [Auteur]
Perrodeau, Elodie [Auteur]
Karras, Alexandre [Auteur]
Khouatra, Chahera [Auteur]
Aumaitre, Olivier [Auteur]
Cohen, Pascal [Auteur]
Decaux, Olivier [Auteur]
Desmurs-Clavel, Helene [Auteur]
Maurier, Francois [Auteur]
Gobert, Pierre [Auteur]
Quemeneur, Thomas [Auteur]
Blanchard-Delaunay, Claire [Auteur]
Bonnotte, Bernard [Auteur]
Carron, Pierre-Louis [Auteur]
Daugas, Eric [Auteur]
Ducret, Marize [Auteur]
Godmer, Pascal [Auteur]
Hamidou, Mohamed [Auteur]
Lidove, Olivier [Auteur]
Limal, Nicolas [Auteur]
Puechal, Xavier [Auteur]
Mouthon, Luc [Auteur]
Ravaud, Philippe [Auteur]
Guillevin, Loic [Auteur]

Journal title :

Annals of the rheumatic diseases

Abbreviated title :

Ann. Rheum. Dis.

Publication date :

2018-05-03

ISSN :

1468-2060

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: To compare long-term efficacy of remission-maintenance regimens in patients with newly diagnosed or relapsing antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides. METHODS: The 28-month ...
Show more >OBJECTIVE: To compare long-term efficacy of remission-maintenance regimens in patients with newly diagnosed or relapsing antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides. METHODS: The 28-month Maintenance of Remission using Rituximab in Systemic ANCA-associated Vasculitis trial compared rituximab with azathioprine to maintain remission in patients with newly diagnosed or relapsing granulomatosis with polyangiitis, microscopic polyangiitis or renal-limited ANCA-associated vasculitis. Thereafter, prospective patient follow-up lasted until month 60. The primary endpoint was the major-relapse rate at month 60. Relapse and serious adverse event-free survival were also assessed. RESULTS: Among the 115 enrolled patients, only one was lost to follow-up at month 60. For the azathioprine and rituximab groups, respectively, at month 60, the major relapse-free survival rates were 49.4% (95% CI 38.0% to 64.3%) and 71.9% (95% CI 61.2% to 84.6%) (p=0.003); minor and major relapse-free survival rates were 37.2% (95% CI 26.5% to 52.2%) and 57.9% (95% CI 46.4% to 72.2%) (p=0.012); overall survival rates were 93.0% (95% CI 86.7% to 99.9%) and 100% (p=0.045) and cumulative glucocorticoid use was comparable. Quality-adjusted time without symptoms and toxicity analysis showed that rituximab-treated patients had 12.6 months more without relapse or toxicity than those given azathioprine (p<0.001). Antiproteinase-3-ANCA positivity and azathioprine arm were independently associated with higher risk of relapse. HRs of positive ANCA to predict relapse increased over time. CONCLUSION: The rate of sustained remission for ANCA-associated vasculitis patients, following rituximab-based or azathioprine-based maintenance regimens, remained superior over 60 months with rituximab, with better overall survival. TRIAL REGISTRATION NUMBER: NCT00748644.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

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

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity
Glycation from inflammation to aging

Submission date :

2019-03-01T14:17:50Z