RT Journal Article SR Electronic T1 Long-term efficacy of remission-maintenance regimens for ANCA-associated vasculitides JF Annals of the Rheumatic Diseases JO Ann Rheum Dis FD BMJ Publishing Group Ltd and European League Against Rheumatism SP 1150 OP 1156 DO 10.1136/annrheumdis-2017-212768 VO 77 IS 8 A1 Benjamin Terrier A1 Christian Pagnoux A1 Élodie Perrodeau A1 Adexandre Karras A1 Chahera Khouatra A1 Olivier Aumaître A1 Pascal Cohen A1 Olivier Decaux A1 Hélène Desmurs-Clavel A1 François Maurier A1 Pierre Gobert A1 Thomas Quémeneur A1 Claire Blanchard-Delaunay A1 Bernard Bonnotte A1 Pierre-Louis Carron A1 Eric Daugas A1 Marize Ducret A1 Pascal Godmer A1 Mohamed Hamidou A1 Olivier Lidove A1 Nicolas Limal A1 Xavier Puéchal A1 Luc Mouthon A1 Philippe Ravaud A1 Loïc Guillevin A1 , YR 2018 UL http://ard.bmj.com/content/77/8/1150.abstract AB 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.