PT  - JOURNAL ARTICLE
AU  - Rachel B Jones
AU  - Shunsuke Furuta
AU  - Jan Willem Cohen Tervaert
AU  - Thomas Hauser
AU  - Raashid Luqmani
AU  - Matthew D Morgan
AU  - Chen Au Peh
AU  - Caroline O Savage
AU  - Marten Segelmark
AU  - Vladimir Tesar
AU  - Pieter van Paassen
AU  - Michael Walsh
AU  - Kerstin Westman
AU  - David RW Jayne
AU  - for the European Vasculitis Society (EUVAS)
TI  - Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis: 2-year results of a randomised trial
AID  - 10.1136/annrheumdis-2014-206404
DP  - 2015 Jun 01
TA  - Annals of the Rheumatic Diseases
PG  - 1178--1182
VI  - 74
IP  - 6
4099  - http://ard.bmj.com/content/74/6/1178.short
4100  - http://ard.bmj.com/content/74/6/1178.full
SO  - Ann Rheum Dis2015 Jun 01; 74
AB  - Objectives The RITUXVAS trial reported similar remission induction rates and safety between rituximab and cyclophosphamide based regimens for antineutrophil cytoplasm antibody (ANCA)-associated vasculitis at 12 months; however, immunosuppression maintenance requirements and longer-term outcomes after rituximab in ANCA-associated renal vasculitis are unknown.Methods Forty-four patients with newly diagnosed ANCA-associated vasculitis and renal involvement were randomised, 3:1, to glucocorticoids plus either rituximab (375 mg/m2/week×4) with two intravenous cyclophosphamide pulses (n=33, rituximab group), or intravenous cyclophosphamide for 3–6 months followed by azathioprine (n=11, control group).Results The primary end point at 24 months was a composite of death, end-stage renal disease and relapse, which occurred in 14/33 in the rituximab group (42%) and 4/11 in the control group (36%) (p=1.00). After remission induction treatment all patients in the rituximab group achieved complete B cell depletion and during subsequent follow-up, 23/33 (70%) had B cell return. Relapses occurred in seven in the rituximab group (21%) and two in the control group (18%) (p=1.00). All relapses in the rituximab group occurred after B cell return.Conclusions At 24 months, rates of the composite outcome of death, end-stage renal disease and relapse did not differ between groups. In the rituximab group, B cell return was associated with relapse.Trial registration number ISRCTN28528813.