TY - JOUR T1 - Rituximab as therapy to induce remission after relapse in ANCA-associated vasculitis JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 1243 LP - 1249 DO - 10.1136/annrheumdis-2019-216863 VL - 79 IS - 9 AU - Rona M Smith AU - Rachel Bronwen Jones AU - Ulrich Specks AU - Simon Bond AU - Marianna Nodale AU - Reem Aljayyousi AU - Jacqueline Andrews AU - Annette Bruchfeld AU - Brian Camilleri AU - Simon Carette AU - Chee Kay Cheung AU - Vimal Derebail AU - Tim Doulton AU - Lindsy Forbess AU - Shouichi Fujimoto AU - Shunsuke Furuta AU - Ora Gewurz-Singer AU - Lorraine Harper AU - Toshiko Ito-Ihara AU - Nader Khalidi AU - Rainer Klocke AU - Curry Koening AU - Yoshinori Komagata AU - Carol Langford AU - Peter Lanyon AU - Raashid Ahmed Luqmani AU - Hirofumi Makino AU - Carole McAlear AU - Paul Monach AU - Larry W Moreland AU - Kim Mynard AU - Patrick Nachman AU - Christian Pagnoux AU - Fiona Pearce AU - Chen Au Peh AU - Charles Pusey AU - Dwarakanathan Ranganathan AU - Rennie L Rhee AU - Robert Spiera AU - Antoine G Sreih AU - Vladimir Tesar AU - Giles Walters AU - Michael H Weisman AU - Caroline Wroe AU - Peter Merkel AU - David Jayne A2 - , Y1 - 2020/09/01 UR - http://ard.bmj.com/content/79/9/1243.abstract N2 - Objectives Evaluation of rituximab and glucocorticoids as therapy to induce remission after relapse in ANCA-associated vasculitis (AAV) in a prospective observational cohort of patients enrolled into the induction phase of the RITAZAREM trial.Methods Patients relapsing with granulomatosis with polyangiitis or microscopic polyangiitis were prospectively enrolled and received remission-induction therapy with rituximab (4×375 mg/m2) and a higher or lower dose glucocorticoid regimen, depending on physician choice: reducing from either 1 mg/kg/day or 0.5 mg/kg/day to 10 mg/day by 4 months. Patients in this cohort achieving remission were subsequently randomised to receive one of two regimens to prevent relapse.Results 188 patients were studied: 95/188 (51%) men, median age 59 years (range 19–89), prior disease duration 5.0 years (range 0.4–34.5). 149/188 (79%) had previously received cyclophosphamide and 67/188 (36%) rituximab. 119/188 (63%) of relapses had at least one major disease activity item, and 54/188 (29%) received the higher dose glucocorticoid regimen. 171/188 (90%) patients achieved remission by 4 months. Only six patients (3.2% of the study population) did not achieve disease control at month 4. Four patients died in the induction phase due to pneumonia (2), cerebrovascular accident (1), and active vasculitis (1). 41 severe adverse events occurred in 27 patients, including 13 severe infections.Conclusions This large prospective cohort of patients with relapsing AAV treated with rituximab in conjunction with glucocorticoids demonstrated a high level of efficacy for the reinduction of remission in patients with AAV who have relapsed, with a similar safety profile to previous studies. ER -