Follow-up data from the RAVE trial have shown that rituximab is as effective as immunosuppression with cyclophosphamide followed by azathioprine in antineutrophil cytoplasmic antibody (ANCA) associated vasculitis. Rituximab is likely to become the standard of care for many patients with ANCA disease. However, an individualized approach is needed to identify those who require more-intense or prolonged therapy.
This is a preview of subscription content, log in via an institution to check access.
References
Stone, J. H. et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N. Engl. J. Med. 363, 221–232 (2010).
Jones, R. B. et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N. Engl. J. Med. 363, 211–220 (2010).
Specks, U. et al. Efficacy of remission-induction regimens for ANCA-associated vasculitis. N. Engl. J. Med. 369, 417–427 (2013).
Fauci, A. S. & Wolff, S. M. Wegener's granulomatosis: studies in eighteen patients and a review of the literature. Medicine (Baltimore) 52, 535–561 (1973).
Heijl, C. et al. Incidence of malignancy in patients treated for antineutrophil cytoplasm antibody-associated vasculitis: follow-up data from European Vasculitis Study Group clinical trials. Ann. Rheum. Dis. 70, 1415–1421 (2011).
de Groot, K. et al. Pulse versus daily oral cyclophosphamide for induction of remission in antineutrophil cytoplasmic antibody-associated vasculitis: a randomized trial. Ann. Intern. Med. 150, 670–680 (2009).
Voswinkel, J., Muller, A. & Lamprecht, P. Is PR3-ANCA formation initiated in Wegener's granulomatosis lesions? Granulomas as potential lymphoid tissue maintaining autoantibody production. Ann. N. Y. Acad. Sci. 1051, 12–19 (2005).
Mansfield, N. et al. Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated vasculitis. Nephrol. Dial. Transplant. 26, 3280–3286 (2011).
Edwards, J. C. et al. Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis. N. Engl. J. Med. 350, 2572–2581 (2004).
Smith, R. M. et al. Rituximab for remission maintenance in relapsing antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum. 64, 3760–3769 (2012).
Acknowledgements
R. Tarzi is supported by a Clinician Scientist Fellowship from Arthritis Research UK.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Tarzi, R., Pusey, C. RAVE about rituximab in ANCA vasculitis?. Nat Rev Nephrol 9, 628–629 (2013). https://doi.org/10.1038/nrneph.2013.204
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrneph.2013.204
- Springer Nature Limited