Background Four times of once-weekly doses of 375 mg/m² rituximab (RTX) are frequently used as remission induction therapy for ANCA-associated vasculitis (AAV). Since this regimen has been basically generated from experience of B-cell non-Hodgkins' lymphoma in the Europe and North America, appropriate dose and interval for patients with AAV in other population have been poorly investigated. Here we comprehensively analyzed the efficacy and tolerability of high or low dose regimen of RTX in Japanese patients with AAV.

Objectives We investigated the efficacy and safety issue of low dose RTX for Japanese patients with AAV.

Methods We retrospectively examined AAV patients who met the 2012 Chapel Hill classification from 2006 to 2016. We divided them into 2 groups, those treated with high-dose (HD) and low-dose (LD) RTX. HD RTX was the original regimen and LD RTX consisted of twice of one-weekly dose of 375 mg/m². We evaluated cumulative complete remission (CR) rate and relapse-free rate for 1.5 years. CR was defined as BVAS=0 and relapse was defined as BVAS≧1.

Results We evaluated 17 patients with HD and 11 patients with LD RTX. Higher percentage of elderly patients was observed in LD group (p<0.01). No significant difference was found in BVAS (p=0.49) and VDI (p=0.15) before treatment. No significant difference was found in cumulative CR rate (p=0.90) (Fig. 1A), relapse-free rate (p=0.48) (Fig. 1B), B cells counts and serious adverse events. We found patients with nasal involvement and pulmonary nodule/cavity formation had higher relapse rate in LD group than those with HD group (p=0.05,and p=0.09 respectively).

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Figure 1

Conclusions LD regimen of RTX, especially in elderly patients, might be effective in remission induction therapy in AAV.

References

1. Ozaki S, et al. Mod Rheumatol 2012; 22: 394–404.

References

Disclosure of Interest None declared