Immunological Medicine (Jan 2025)
Effectiveness for remission maintenance rate and safety of different rituximab regimens for treating anti-neutrophil cytoplasmic antibody-associated vasculitis in Japan: a J-CANVAS study
- Chie Ogita,
- Kazuteru Noguchi,
- Jiro Takeuchi,
- Naoto Azuma,
- Satoshi Omura,
- Daiki Nakagomi,
- Yoshiyuki Abe,
- Masatoshi Kadoya,
- Naoho Takizawa,
- Atsushi Nomura,
- Yuji Kukida,
- Naoya Kondo,
- Yasuhiko Yamano,
- Takuya Yanagida,
- Koji Endo,
- Shintaro Hirata,
- Tohru Takeuchi,
- Kunihiro Ichinose,
- Masaru Kato,
- Ryo Yanai,
- Yusuke Matsuo,
- Yasuhiro Shimojima,
- Ryo Nishioka,
- Ryota Okazaki,
- Tomoaki Takata,
- Takafumi Ito,
- Mayuko Moriyama,
- Ayuko Takatani,
- Yoshia Miyawaki,
- Yutaka Kawahito,
- Toshiko Ito-Ihara,
- Takashi Kida,
- Nobuyuki Yajima,
- Takashi Kawaguchi,
- Kiyoshi Matsui
Affiliations
- Chie Ogita
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University School of Medicine, Hyogo, Japan
- Kazuteru Noguchi
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University School of Medicine, Hyogo, Japan
- Jiro Takeuchi
- Hyogo Medical University Clinical Epidemiology, Hyogo, Japan
- Naoto Azuma
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University School of Medicine, Hyogo, Japan
- Satoshi Omura
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Daiki Nakagomi
- Department of Rheumatology, University of Yamanashi Hospital, Yamanashi, Japan
- Yoshiyuki Abe
- Department of Internal Medicine and Rheumatology, Juntendo University, Tokyo, Japan
- Masatoshi Kadoya
- Center for Rheumatic Disease, Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, Japan
- Naoho Takizawa
- Department of Rheumatology, Chubu Rosai Hospital, Aichi, Japan
- Atsushi Nomura
- Immuno-Rheumatology Center, St. Luke’s International Hospital, Tokyo, Japan
- Yuji Kukida
- Department of Rheumatology, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto, Japan
- Naoya Kondo
- Department of Nephrology, Kyoto Katsura Hospital, Kyoto, Japan
- Yasuhiko Yamano
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Aichi, Japan
- Takuya Yanagida
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima, Japan
- Koji Endo
- Department of General Internal Medicine, Tottori Redcross Hospital, Tottori, Japan
- Shintaro Hirata
- Department of Clinical Immunology and Rheumatology, Hiroshima University Hospital, Hiroshima, Japan
- Tohru Takeuchi
- Department of Internal Medicine (IV), Osaka Medical and Pharmaceutical University, Osaka, Japan
- Kunihiro Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Masaru Kato
- Division of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
- Ryo Yanai
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Yusuke Matsuo
- Department of Rheumatology, Tokyo Kyosai Hospital, Tokyo, Japan
- Yasuhiro Shimojima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Matsumoto, Japan
- Ryo Nishioka
- Department of Rheumatology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
- Ryota Okazaki
- Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
- Tomoaki Takata
- Division of Gastroenterology and Nephrology, Tottori University, Yonago, Japan
- Takafumi Ito
- Division of Nephrology, Department of Internal Medicine, Teikyo University Chiba Medical Center, Chiba, Japan
- Mayuko Moriyama
- Department of Rheumatology, Shimane University Faculty of Medicine, Shimane, Japan
- Ayuko Takatani
- Rheumatic Disease Center, Sasebo Chuo Hospital, Nagasaki, Japan
- Yoshia Miyawaki
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Yutaka Kawahito
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Toshiko Ito-Ihara
- The Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Takashi Kida
- Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Nobuyuki Yajima
- Division of Rheumatology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan
- Takashi Kawaguchi
- Department of Practical Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
- Kiyoshi Matsui
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo Medical University School of Medicine, Hyogo, Japan
Abstract
Rituximab (RTX) has been reported to effectively maintain remission in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). In this multicenter study involving 57 patients who achieved remission after 24 weeks, we evaluated the effectiveness of RTX in maintaining remission in patients with AAV. Patients were divided into three groups based on RTX administration: continuous, induction phase-only, and maintenance phase-only groups. The continuous group had a remission maintenance rate after 48 weeks of treatment compared with the induction phase-only group (100% vs. 88.2%, p = 0.29). More patients in the continuous group received three or more RTX doses during the induction period (82.4% vs. 52.9%, p = 0.06), and this group had a lower incidence of infection (5.9% vs. 29.4%, p = 0.08). Compared with the maintenance-only group, the continuous group had a numerically higher proportion of patients in remission after 48 weeks of treatment (100% vs. 83.3%, p = 0.26) and a lower incidence of infection (5.9% vs. 50%, p = 0.04); however, the N in the maintenance phase was small and suspected to have low power. Regardless of the method of RTX administration (induction phase-only or continuous), administering RTX during the induction phase may be crucial for achieving remission.
Keywords
- Anti-neutrophil cytoplasmic antibody-associated vasculitis
- induction phase of remission
- maintenance phase of remission
- regular administration
- rituximab
