Related Experiment Video

Updated: Sep 11, 2025

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

7.3K

Rituximab versus azathioprine in maintenance therapy of patients with granulomatosis with polyangiitis

Samira Alesaeidi1, Masoud Radnia2, Soheil Tavakolpour3

  • 1Department of Internal Medicine and Rheumatology, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Caspian Journal of Internal Medicine
|August 11, 2025
PubMed
Abstract

Insights

Rituximab (RTX) maintenance therapy significantly reduces relapse rates in Granulomatosis with polyangiitis (GPA) compared to Azathioprine (AZA). Both treatments showed similar complication rates in this GPA study.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis affecting small to medium-sized blood vessels.
  • GPA is characterized by granuloma formation and inflammation, leading to organ damage.

Purpose of the Study:

  • To compare the efficacy and safety of rituximab (RTX) versus azathioprine (AZA) for maintenance treatment in patients with GPA.
  • To assess relapse rates, disease activity scores, and treatment complications in GPA patients receiving RTX or AZA.

Main Methods:

  • Retrospective cohort study analyzing medical records of recently diagnosed GPA patients.
  • Follow-up period of 18-24 months, comparing relapse frequency, Birmingham Vasculitis Activity Score-Wegner specific (BVAS-WG), and vasculitis damage index (VDI).

Main Results:

  • RTX maintenance was associated with a significantly lower relapse rate (18.6%) compared to AZA (66.6%) (Hazard Ratio = 6.9, p <0.001).
  • The RTX group showed a significantly lower increase in BVAS-WG score (p <0.001).
  • Treatment-related complications were similar between the RTX and AZA groups (p >0.05).

Conclusions:

  • Rituximab (RTX) demonstrates superior efficacy over azathioprine (AZA) in reducing relapse rates for GPA maintenance therapy.
  • RTX offers a better treatment response without an increase in treatment complications compared to AZA.
Keywords:
Antineutrophilic Cytoplasmic Antibody (ANCA)AzathioprineGranulomatosis with polyangiitis (GPA)Rituximab

More Related Videos

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

335
Adoptive Immunotherapy of iNKT Cells in Glucose-6-Phosphate Isomerase G6PI-Induced RA Mice08:43

Adoptive Immunotherapy of iNKT Cells in Glucose-6-Phosphate Isomerase G6PI-Induced RA Mice

Published on: January 31, 2020

6.9K

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
271
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
232
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
189
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
32
Myasthenia Gravis: Overview and Treatment01:20

Myasthenia Gravis: Overview and Treatment

Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...
1.9K
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
203