Rituximab as maintenance therapy for ANCA associated vasculitis: how, when and why?
Marco A Alba1, Luis Felipe Flores-Suárez1
1Clínica de Vasculitis Sistémicas Primarias, Instituto Nacional de Enfermedades Respiratorias, México Distrito Federal, México.
Abstract:
ANCA-associated vasculitides (AAV) are chronic autoimmune diseases characterized by inflammation and destruction of small vessels. Rituximab is now licensed for use as a remission-induction agent in the treatment of these disorders. During recent years, several non-controlled studies have suggested that rituximab may be of value in maintaining disease remission in AAV. In these series, 3 techniques have been tried: "watch-and-wait", repeated cycles in fixed intervals, or administration based on proposed biomarkers. More importantly, the results of the MAINRITSAN trial showed that this anti-CD20 agent is superior to azathioprine for preventing major relapses in AAV. This review summarizes current information regarding the effectiveness, timing, dosing, duration and safety of rituximab as a valid option for remission maintenance.
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