A comparison of rituximab with cyclophosphamide in terms of efficacy and complications as induction therapy for treating granulomatosis with polyangiitis: A three-center study.

IF 1.3 Q4 RHEUMATOLOGY
Maryam Tavakoli Chaleshtori, Ziba Farajzadegan, Mansour Salesi
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引用次数: 1

Abstract

Objective: Granulomatosis with polyangiitis (GPA), formerly known as Wegner's granulomatosis, is a rare vasculitic syndrome classified under Anti-Neutrophilic Cytoplasmic Autoantibody (ANCA)-associ- ated vasculitides, which is fatal if untreated. The mainstay of treatment consists of immunosuppression using a combination of corticosteroids with either rituximab (RTX) or cyclophosphamide (CYC). We aimed to compare the 4-year clinical outcomes between patients with GPA receiving CYC and RTX as remission induction.

Methods: In this retrospective cohort, we used patient data from 92 patients with GPA at two large teaching hospitals and a private clinic in Isfahan, Iran. The patients were classified based on the medi- cation they received for remission induction into RTX and CYC groups. The main outcomes were rate of death and relapse, disease activity assessed based on the Birmingham Vasculitis Activity Score (BVAS), disease-related complications, laboratory markers, and adverse-drug-reactions.

Results: Fifty-three (57.6%) patients received CYC, whereas 39 (42.4%) received RTX. The mean duration of follow-up was 3.6 (62) years. Most of patients (70%) had a successful remission, while 20.7% experi- enced a relapse and 8.7% of patients died. The rate of death and relapse did not differ between the RTX and CYC groups. Disease-related complications involved an insignificantly higher proportion of patients in the CYC (12/53) group than the RTX (4/39) group. Patients in both groups showed a signifi- cant decrease in BVAS during follow-ups irrespective of the medication exposure. The rate of adverse events was similarly low (n 1⁄4 1) in both groups.

Conclusion: RTX and CYC were similar in inducing remission and reducing adverse clinical outcomes among patients with GPA with acceptable side effect profiles.

Abstract Image

Abstract Image

利妥昔单抗与环磷酰胺诱导治疗肉芽肿合并多血管炎的疗效及并发症比较:一项三中心研究。
目的:肉芽肿病合并多血管炎(GPA),以前称为韦格纳肉芽肿病,是一种罕见的血管增生综合征,属于抗中性粒细胞自身抗体(ANCA)相关的血管增生,如果不治疗是致命的。主要的治疗包括免疫抑制,使用糖皮质激素联合利妥昔单抗(RTX)或环磷酰胺(CYC)。我们的目的是比较接受CYC和RTX作为缓解诱导的GPA患者的4年临床结果。方法:在这个回顾性队列研究中,我们使用了来自伊朗伊斯法罕两家大型教学医院和一家私人诊所的92名GPA患者的患者资料。根据患者接受的缓解诱导药物分为RTX组和CYC组。主要结局是死亡率和复发率、基于伯明翰血管炎活动度评分(BVAS)评估的疾病活动度、疾病相关并发症、实验室标志物和药物不良反应。结果:53例(57.6%)患者接受CYC治疗,39例(42.4%)患者接受RTX治疗。平均随访时间为3.6(62)年。大多数患者(70%)成功缓解,20.7%复发,8.7%死亡。RTX组和CYC组之间的死亡率和复发率没有差异。CYC(12/53)组的疾病相关并发症发生率不显著高于RTX(4/39)组。两组患者在随访期间均显示BVAS显著下降,与药物暴露无关。两组不良事件发生率同样低(n 1 / 4 1)。结论:在副作用可接受的GPA患者中,RTX和CYC在诱导缓解和减少不良临床结局方面相似。
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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