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

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Caspian Journal of Internal Medicine Pub Date : 2025-06-23 eCollection Date: 2025-01-01 DOI:10.22088/cjim.16.3.480
Samira Alesaeidi, Masoud Radnia, Soheil Tavakolpour, Seyed Behnam Jazayeri, Shima Loni
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引用次数: 0

Abstract

Background: Granulomatosis with polyangiitis (GPA) is a rare disease affecting medium-small vessels, causing granuloma formation and inflammation. This study aimed to assess the efficacy and safety of RTX versus Azathioprine (AZA) for maintenance treatment in GPA patients.

Methods: This retrospective cohort study involved a review of medical records of recently diagnosed GPA patients undergoing maintenance treatment with RTX or AZA. The main variable was the frequency of relapses within an 18-month follow-up period. Additionally, the study compared changes in BVAS.WG score (The Birmingham Vasculitis Activity Score-Wegner specific) and Damage (vasculitis damage index (VDI)), mortality, and treatment complications between the two groups.

Results: Among the 43 patients receiving RTX maintenance treatment, 8 (18.6%) experienced relapses during 24 months follow-up, while 14 (66.6%) out of the 21 patients receiving AZA relapsed (Hazard Ratio = 6.9 and 95% confidence interval = 1.95-19.3, p <001). Notably, the increase in the BVAS-WG score was significantly lower in the RTX group compared to the AZA group (p <001). The cumulative steroid dose was 143±21 mg in the RTX group and 125±25 mg in the AZA group (P = 0.1). Treatment side effects were similar in both groups (p >0.05).

Conclusion: Maintenance treatment with RTX is associated with better treatment response and lower relapse rate compared to AZA. There was no difference in treatment complications between AZA or RTX in maintenance treatment.

利妥昔单抗与硫唑嘌呤在肉芽肿合并多血管炎患者维持治疗中的比较。
背景:肉芽肿病合并多血管炎(GPA)是一种少见的影响中小血管的疾病,可引起肉芽肿形成和炎症。本研究旨在评估RTX与硫唑嘌呤(AZA)在GPA患者维持治疗中的有效性和安全性。方法:本回顾性队列研究回顾了最近确诊的GPA患者接受RTX或AZA维持治疗的医疗记录。主要变量是18个月随访期间的复发频率。此外,该研究还比较了BVAS的变化。两组间WG评分(伯明翰血管炎活动评分- wegner特异性)和损伤(血管炎损伤指数(VDI))、死亡率和治疗并发症的比较。结果:在接受RTX维持治疗的43例患者中,随访24个月复发8例(18.6%),而接受AZA治疗的21例患者中复发14例(66.6%)(风险比= 6.9,95%可信区间= 1.95 ~ 19.3,p 0.05)。结论:与AZA相比,RTX维持治疗具有更好的治疗效果和更低的复发率。在维持治疗中,AZA与RTX治疗并发症无差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Caspian Journal of Internal Medicine
Caspian Journal of Internal Medicine MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
7.10%
发文量
90
审稿时长
20 weeks
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