Rituximab in ANCA-associated vasculitis: fad or fact?

A number of case reports and case series of patients with Wegener's granulomatosis, microscopic polyangiitis and Churg-Strauss syndrome have supported the use of rituximab (RTX) for the treatment of refractory ANCA-associated vasculitis (AAV). Whether B cell depletion with RTX could replace cyclophosphamide as a first-line therapy for patients with severe AAV remains to be proven. Two studies, recently published in the New England Journal of Medicine, have examined the efficacy of RTX in inducing remission in patients with severe AAV.