Login Register Cart 0
Generic placeholder image

Current Drug Targets

Editor-in-Chief

ISSN (Print): 1389-4501
ISSN (Online): 1873-5592

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Two Decades Rituximab Therapy in Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis

Author(s): Mohammad Amin Habibi, Sajjad Ahmadpour*, Javad Tafaroji, Seyed Mohammad Eazi, Poriya Minaee, Yousef Mohammadpour and Soheil Tavakolpour*

Volume 26, Issue 2, 2025

Published on: 23 September, 2024

Page: [73 - 87] Pages: 15

DOI: 10.2174/0113894501323529240910015912

Price: $65

TIMBC 2025
Abstract

Remission failure and relapse numerate as one of the main problems in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAVs). The need for new agents that provide effective and safe induction accompanied by sustained remission seems to be urgent in clinical care. The efficacy and safety of rituximab (RTX) for AAVs therapy has been reported in various studies. RTX therapy offers several advantages to treating AAVs patients compared to other therapeutic approaches including reduction of Glucocorticoids (GCs) and conventional Immunosuppressive therapy (IST) usage during both the induction of remission and maintenance phases. This reduction can lead to a lower rate of serious complications making RTX therapy a safer option. It seems that RTX may provide improved clinical outcomes in these patients mediated via B-lymphocyte depletion, Proteinase 3-antineutrophilic cytoplasmic antibody (PR3-ANCA), and myeloperoxidase-antineutrophilic cytoplasmic antibody (MPO-ANCA) titers reduction. In this regard, some uncertainties have been reported to validate the association between such depletion and clinical improvement, as suggested by other sources of autoreactive B cells that did not target with RTX. Due to the prolonged B cell depletion, fixed intervals and adjusted dosage of RTX may be required in patients with AAVs. In this narrative review, we aimed to insight better understand regarding the efficacy of RTX for effective induction and sustained remission in patients with AAVs. It seems that discovering new biomarkers predicting relapse in AAVs patients can lead to future targeted therapy.

Keywords: Rituximab, Immunopharmacology, wegner, MPO-associated vasculitis, PR3-associated vasculitis, small vessel vasculitis.

« Previous
Graphical Abstract

[1]
Fijołek J, Wiatr E. Antineutrophil cytoplasmic antibodies – Their role in pathogenesis, diagnosis and treatment monitoring of ANCA-associated vasculitis. Cent Eur J Immunol 2020; 45(2): 218-27.
[http://dx.doi.org/10.5114/ceji.2019.92494] [PMID: 33456335]
[2]
Hunter RW, Welsh N, Farrah TE, Gallacher PJ, Dhaun N. ANCA associated vasculitis. Br Med J 2020; 369: m1070.
[http://dx.doi.org/10.1136/bmj.m1070] [PMID: 32291255]
[3]
Koening CL, von Hennigs I. Antineutrophil cytoplasmic antibody (ANCA) vasculitis: Pathophysiology, diagnosis, and the evolving treatment landscape. Am J Manag Care 2021; 27(15): S267-76.
[PMID: 34473462]
[4]
Watts RA, Hatemi G, Burns JC, Mohammad AJ. Global epidemiology of vasculitis. Nat Rev Rheumatol 2022; 18(1): 22-34.
[http://dx.doi.org/10.1038/s41584-021-00718-8] [PMID: 34853411]
[5]
Daikeler T, Kistler AD, Martin PY, Vogt B, Huynh-Do U. The role of rituximab in the treatment of ANCA-associated vasculitides (AAV). Swiss Med Wkly 2015; 145: w14103.
[http://dx.doi.org/10.4414/smw.2015.14103] [PMID: 25658140]
[6]
Russell KA, Fass DN, Specks U. Antineutrophil cytoplasmic antibodies reacting with the pro form of proteinase 3 and disease activity in patients with Wegener’s granulomatosis and microscopic polyangiitis. Arthritis Rheum 2001; 44(2): 463-8.
[PMID: 11229478]
[7]
Clain JM, Cartin-Ceba R, Fervenza FC, Specks U. Experience with rituximab in the treatment of antineutrophil cytoplasmic antibody associated vasculitis. Ther Adv Musculoskelet Dis 2014; 6(2): 58-74.
[http://dx.doi.org/10.1177/1759720X13516239] [PMID: 24688606]
[8]
Liu L, Lu H, Zou G, et al. Efficacy and safety of low-dose rituximab as induction therapy for antineutrophil cytoplasmic antibody-associated vasculitis with renal involvement: A Chinese case series. BMC Nephrol 2023; 24(1): 28.
[http://dx.doi.org/10.1186/s12882-023-03075-8] [PMID: 36755215]
[9]
Morel P, Karras A, Porcher R, et al. Management of severe renal disease in anti-neutrophil-cytoplasmic-antibody-associated vasculitis: The place of rituximab and plasma exchange? Rheumatology (Oxford) 2022; 61(10): 4056-64.
[http://dx.doi.org/10.1093/rheumatology/keac046] [PMID: 35108368]
[10]
Jain S, Naidu GSRSNK, Sharma A. Rituximab versus cyclophosphamide for remission induction in active, severe antineutrophil cytoplasmic antibody–associated vasculitis: Comment on the article by Chung et al. Arthritis Rheumatol 2022; 74(3): 544-5.
[http://dx.doi.org/10.1002/art.42002] [PMID: 34694068]
[11]
Lee YH, Song GG. Comparative efficacy and safety of rituximab, mycophenolate, methotrexate, and cyclophosphamide versus azathioprine as maintenance therapy in antineutrophil cytoplasmic antibody-associated vasculitis: A Bayesian network meta-analysis of randomized co. Int J Clin Pharmacol Ther 2022; 60(2): 97-105.
[http://dx.doi.org/10.5414/CP204053] [PMID: 34622770]
[12]
Martinez Del Pero M, Chaudhry A, Jones RB, Sivasothy P, Jani P, Jayne D. B-cell depletion with rituximab for refractory head and neck Wegener’s granulomatosis: A cohort study. Clin Otolaryngol 2009; 34(4): 328-35.
[http://dx.doi.org/10.1111/j.1749-4486.2009.01968.x] [PMID: 19673980]
[13]
Jones RB, Cohen Tervaert JW, Hauser T, et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med 2010; 363(3): 211-20.
[http://dx.doi.org/10.1056/NEJMoa0909169] [PMID: 20647198]
[14]
Specks U, Merkel PA, Seo P, et al. Efficacy of remission-induction regimens for ANCA-associated vasculitis. N Engl J Med 2013; 369(5): 417-27.
[http://dx.doi.org/10.1056/NEJMoa1213277] [PMID: 23902481]
[15]
Azar L, Springer J, Langford CA, Hoffman GS. Rituximab with or without a conventional maintenance agent in the treatment of relapsing granulomatosis with polyangiitis (Wegener’s): a retrospective single-center study. Arthritis Rheumatol 2014; 66(10): 2862-70.
[http://dx.doi.org/10.1002/art.38744] [PMID: 24943239]
[16]
Lionaki S, Fragoulis GE, Venetsanopoulou A, Vlachoyiannopoulos P, Boletis JN, Tzioufas AG. Cyclophosphamide followed by rituximab for aggressive multiple-relapsing antineutrophil cytoplasmic antibody-associated vasculitis. Clin Exp Rheumatol 2017; 35((Suppl 103)): S155-64.
[17]
Roccatello D, Sciascia S, Rossi D, et al. Long-term effects of rituximab added to cyclophosphamide in refractory patients with vasculitis. Am J Nephrol 2011; 34(2): 175-80.
[http://dx.doi.org/10.1159/000329535] [PMID: 21757891]
[18]
Pugnet G, Pagnoux C, Terrier B, et al. Rituximab versus azathioprine for ANCA-associated vasculitis maintenance therapy: impact on global disability and health-related quality of life. Clin Exp Rheumatol 2016; 34(3): S54-9.
[PMID: 27049404]
[19]
Yates M, Watts RA, Bajema IM, et al. EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis. Ann Rheum Dis 2016; 75(9): 1583-94.
[http://dx.doi.org/10.1136/annrheumdis-2016-209133] [PMID: 27338776]
[20]
Montante A, Le Bras A, Pagnoux C, et al. Cost-effectiveness of rituximab versus azathioprine for maintenance treatment in antineutrophil cytoplasmic antibody-associated vasculitis. Clin Exp Rheumatol 2019; 37(2): 137-43.
[PMID: 31162031]
[21]
Rhee EP, Laliberte KA, Niles JL. Rituximab as maintenance therapy for anti-neutrophil cytoplasmic antibody-associated vasculitis. Clin J Am Soc Nephrol 2010; 5(8): 1394-400.
[http://dx.doi.org/10.2215/CJN.08821209] [PMID: 20498238]
[22]
Miloslavsky EM, Specks U, Merkel PA, et al. Outcomes of nonsevere relapses in antineutrophil cytoplasmic antibody-associated vasculitis treated with glucocorticoids. Arthritis Rheumatol 2015; 67(6): 1629-36.
[http://dx.doi.org/10.1002/art.39104] [PMID: 25776953]
[23]
Holle JU, Dubrau C, Herlyn K, et al. Rituximab for refractory granulomatosis with polyangiitis (Wegener’s granulomatosis): comparison of efficacy in granulomatous versus vasculitic manifestations. Ann Rheum Dis 2012; 71(3): 327-33.
[http://dx.doi.org/10.1136/ard.2011.153601] [PMID: 22021864]
[24]
Takeyama Y, Ono N, Shirahama Y, et al. Rituximab maintenance therapy for patients with antineutrophil cytoplasmic antibody-associated vasculitis in Japan. Mod Rheumatol 2021; 31(2): 408-16.
[http://dx.doi.org/10.1080/14397595.2020.1790778] [PMID: 32615836]
[25]
Weiner M, Goh SM, Mohammad AJ, et al. Effect of treatment on damage and hospitalization in elderly patients with microscopic polyangiitis and granulomatosis with polyangiitis. J Rheumatol 2020; 47(4): 580-8.
[http://dx.doi.org/10.3899/jrheum.190019] [PMID: 31308208]
[26]
Mendel A, Pagnoux C. Use of rituximab for the treatment of antineutrophil cytoplasm antibody–associated vasculitis in Canada, 2010–2020. J Rheumatol 2021; 48(11): 1755-6.
[http://dx.doi.org/10.3899/jrheum.210537] [PMID: 34470792]
[27]
James KE, Xiao R, Merkel PA, Weiss PF. Variation in the treatment of children hospitalized with antineutrophil cytoplasmic antibody–associated vasculitis in the US. Arthritis Care Res (Hoboken) 2017; 69(9): 1377-83.
[http://dx.doi.org/10.1002/acr.23142] [PMID: 27813340]
[28]
Cartin-Ceba R, Diaz-Caballero L, Al-Qadi MO, et al. Diffuse alveolar hemorrhage secondary to antineutrophil cytoplasmic antibody–associated vasculitis: Predictors of respiratory failure and clinical outcomes. Arthritis Rheumatol 2016; 68(6): 1467-76.
[http://dx.doi.org/10.1002/art.39562] [PMID: 26713723]
[29]
Chasseur P, Blockmans D, von Frenckell C, Nicolas J-B, Regniers C, Vandergheynst F. Rituximab prescription patterns and efficacy in the induction treatment of ANCA-associated vasculitis in a Belgian multicenter cohort. Acta Clin Belg 2020; 75(3): 163-9.
[http://dx.doi.org/10.1080/17843286.2019.1578041] [PMID: 30767717]
[30]
McAdoo SP, Medjeral-Thomas N, Gopaluni S, et al. Long-term follow-up of a combined rituximab and cyclophosphamide regimen in renal anti-neutrophil cytoplasm antibody-associated vasculitis. Nephrol Dial Transplant 2019; 34(1): 63-73.
[http://dx.doi.org/10.1093/ndt/gfx378] [PMID: 29462348]
[31]
Charles P, Néel A, Tieulié N, et al. Rituximab for induction and maintenance treatment of ANCA-associated vasculitides: a multicentre retrospective study on 80 patients. Rheumatology (Oxford) 2014; 53(3): 532-9.
[http://dx.doi.org/10.1093/rheumatology/ket381] [PMID: 24282319]
[32]
Pendergraft WF III, Cortazar FB, Wenger J, et al. Long-term maintenance therapy using rituximab-induced continuous B-cell depletion in patients with ANCA vasculitis. Clin J Am Soc Nephrol 2014; 9(4): 736-44.
[http://dx.doi.org/10.2215/CJN.07340713] [PMID: 24626432]
[33]
Calich AL, Puéchal X, Pugnet G, et al. Rituximab for induction and maintenance therapy in granulomatosis with polyangiitis (Wegener’s). Results of a single-center cohort study on 66 patients. J Autoimmun 2014; 50: 135-41.
[http://dx.doi.org/10.1016/j.jaut.2014.03.002] [PMID: 24703438]
[34]
Bénard V, Farhat C, Zarandi-Nowroozi M, et al. Comparison of two rituximab induction regimens for antineutrophil cytoplasm antibody–associated vasculitis: Systematic review and meta-analysis. ACR Open Rheumatol 2021; 3(7): 484-94.
[http://dx.doi.org/10.1002/acr2.11274] [PMID: 34114739]
[35]
Smith RM, Jones RB, Guerry MJ, et al. Rituximab for remission maintenance in relapsing antineutrophil cytoplasmic antibody–associated vasculitis. Arthritis Rheum 2012; 64(11): 3760-9.
[http://dx.doi.org/10.1002/art.34583] [PMID: 22729997]
[36]
Knight A, Hallenberg H, Baecklund E. Efficacy and safety of rituximab as maintenance therapy for relapsing granulomatosis with polyangiitis - A case series. Clin Rheumatol 2014; 33(6): 841-8.
[http://dx.doi.org/10.1007/s10067-013-2351-y] [PMID: 23959445]
[37]
Puéchal X, Iudici M, Calich AL, et al. Rituximab for induction and maintenance therapy of granulomatosis with polyangiitis: A single-centre cohort study on 114 patients. Rheumatology (Oxford) 2019; 58(3): 401-9.
[http://dx.doi.org/10.1093/rheumatology/key117] [PMID: 29722877]
[38]
Thietart S, Karras A, Augusto J-F, et al. Evaluation of rituximab for induction and maintenance therapy in patients 75 years and older with antineutrophil cytoplasmic antibody-associated vasculitis. JAMA Netw Open 2022; 5(7): e222092.
[http://dx.doi.org/10.1001/jamanetworkopen.2022.20925]
[39]
Besada E, Koldingsnes W, Nossent JC. Long-term efficacy and safety of pre-emptive maintenance therapy with rituximab in granulomatosis with polyangiitis: Results from a single centre. Rheumatology (Oxford) 2013; 52(11): 2041-7.
[http://dx.doi.org/10.1093/rheumatology/ket257] [PMID: 23934313]
[40]
Harper L, Morgan MD, Walsh M, et al. Pulse versus daily oral cyclophosphamide for induction of remission in ANCA-associated vasculitis: Long-term follow-up. Ann Rheum Dis 2012; 71(6): 955-60.
[http://dx.doi.org/10.1136/annrheumdis-2011-200477] [PMID: 22128076]
[41]
Stone JH, Merkel PA, Spiera R, et al. Rituximab versus cyclophosphamide for ANCA-associated vasculitis. N Engl J Med 2010; 363(3): 221-32.
[http://dx.doi.org/10.1056/NEJMoa0909905] [PMID: 20647199]
[42]
McGregor JG, Hogan SL, Kotzen ES, et al. Rituximab as an immunosuppressant in antineutrophil cytoplasmic antibody-associated vasculitis. Nephrol Dial Transplant 2015; 30(suppl 1): i123-31.
[http://dx.doi.org/10.1093/ndt/gfv076]
[43]
Alberici F, Smith RM, Jones RB, et al. Long-term follow-up of patients who received repeat-dose rituximab as maintenance therapy for ANCA-associated vasculitis. Rheumatology (Oxford) 2015; 54(7): 1153-60.
[http://dx.doi.org/10.1093/rheumatology/keu452] [PMID: 25477054]
[44]
Cartin-Ceba R, Golbin JM, Keogh KA, et al. Rituximab for remission induction and maintenance in refractory granulomatosis with polyangiitis (Wegener’s): Ten-year experience at a single center. Arthritis Rheum 2012; 64(11): 3770-8.
[http://dx.doi.org/10.1002/art.34584] [PMID: 22730028]
[45]
Mansfield N, Hamour S, Habib AM, et al. Prolonged disease-free remission following rituximab and low-dose cyclophosphamide therapy for renal ANCA-associated vasculitis. Nephrol Dial Transplant 2011; 26(10): 3280-6.
[http://dx.doi.org/10.1093/ndt/gfr127] [PMID: 21414973]
[46]
Braun-Moscovici Y, Butbul-Aviel Y, Guralnik L, et al. Rituximab: Rescue therapy in life-threatening complications or refractory autoimmune diseases: a single center experience. Rheumatol Int 2013; 33(6): 1495-504.
[http://dx.doi.org/10.1007/s00296-012-2587-x] [PMID: 23239037]
[47]
Roubaud-Baudron C, Pagnoux C, Méaux-Ruault N, et al. Rituximab maintenance therapy for granulomatosis with polyangiitis and microscopic polyangiitis. J Rheumatol 2012; 39(1): 125-30.
[http://dx.doi.org/10.3899/jrheum.110143] [PMID: 22089465]
[48]
Jones RB, Ferraro AJ, Chaudhry AN, et al. A multicenter survey of rituximab therapy for refractory antineutrophil cytoplasmic antibody–associated vasculitis. Arthritis Rheum 2009; 60(7): 2156-68.
[http://dx.doi.org/10.1002/art.24637] [PMID: 19565480]
[49]
Mittal S, Naidu GSRSNK, Jha S, et al. Experience with similar biologic rituximab in 77 patients of granulomatosis with polyangiitis - A real-life experience. Clin Rheumatol 2021; 40(2): 645-51.
[http://dx.doi.org/10.1007/s10067-020-05261-7] [PMID: 32656662]
[50]
Brihaye B, Aouba A, Pagnoux C, Cohen P, Lacassin F, Guillevin L. Adjunction of rituximab to steroids and immunosuppressants for refractory/relapsing Wegener’s granulomatosis: A study on 8 patients. Clin Exp Rheumatol 2007; 25(1): S23-7.
[PMID: 17428359]
[51]
Rees F, Yazdani R, Lanyon P. Long-term follow-up of different refractory systemic vasculitides treated with rituximab. Clin Rheumatol 2011; 30(9): 1241-5.
[http://dx.doi.org/10.1007/s10067-011-1756-8] [PMID: 21523362]
[52]
Charles P, Terrier B, Perrodeau É, et al. Comparison of individually tailored versus fixed-schedule rituximab regimen to maintain ANCA-associated vasculitis remission: Results of a multicentre, randomised controlled, phase III trial (MAINRITSAN2). Ann Rheum Dis 2018; 77(8): 1143-9.
[http://dx.doi.org/10.1136/annrheumdis-2017-212878] [PMID: 29695500]
[53]
Miloslavsky EM, Specks U, Merkel PA, et al. Rituximab for the treatment of relapses in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol 2014; 66(11): 3151-9.
[http://dx.doi.org/10.1002/art.38788] [PMID: 25047592]
[54]
Lovric S, Erdbruegger U, Kümpers P, et al. Rituximab as rescue therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis: A single-centre experience with 15 patients. Nephrol Dial Transplant 2008; 24(1): 179-85.
[http://dx.doi.org/10.1093/ndt/gfn430] [PMID: 18685144]
[55]
Tieu J, Smith R, Basu N, et al. Rituximab for maintenance of remission in ANCA-associated vasculitis: Expert consensus guidelines-Executive summary. Rheumatology (Oxford) 2020; 59(4): 727-31.
[http://dx.doi.org/10.1093/rheumatology/kez632] [PMID: 32096542]
[56]
Aries PM, Hellmich B, Voswinkel J, et al. Lack of efficacy of rituximab in Wegener’s granulomatosis with refractory granulomatous manifestations. Ann Rheum Dis 2005; 65(7): 853-8.
[http://dx.doi.org/10.1136/ard.2005.044420] [PMID: 16269425]
[57]
Ooka S, Maeda A, Ito H, Omata M, Yamada H, Ozaki S. Treatment of refractory retrobulbar granuloma with rituximab in a patient with ANCA-negative Wegener’s granulomatosis: A case report. Mod Rheumatol 2009; 19(1): 80-3.
[http://dx.doi.org/10.3109/s10165-008-0119-z] [PMID: 18806927]
[58]
Khan A, Lawson CA, Quinn MA, Isdale AH, Green MJ. Successful treatment of ANCA-negative wegener’s granulomatosis with rituximab. Int J Rheumatol 2010; 2010: 1-2.
[http://dx.doi.org/10.1155/2010/846063] [PMID: 21049001]
[59]
Land J, Abdulahad WH, Arends S, et al. Prospective monitoring of in vitro produced PR3-ANCA does not improve relapse prediction in granulomatosis with polyangiitis. PLoS One 2017; 12(8): e0182549.
[http://dx.doi.org/10.1371/journal.pone.0182549] [PMID: 28771641]
[60]
Thiel J, Rizzi M, Engesser M, et al. B cell repopulation kinetics after rituximab treatment in ANCA-associated vasculitides compared to rheumatoid arthritis, and connective tissue diseases: A longitudinal observational study on 120 patients. Arthritis Res Ther 2017; 19(1): 101.
[http://dx.doi.org/10.1186/s13075-017-1306-0] [PMID: 28521808]
[61]
Urlaub D, Zhao S, Blank N, et al. Activation of natural killer cells by rituximab in granulomatosis with polyangiitis. Arthritis Res Ther 2019; 21(1): 277.
[http://dx.doi.org/10.1186/s13075-019-2054-0] [PMID: 31829278]
[62]
Smith RM, Jones RB, Specks U, et al. Rituximab as therapy to induce remission after relapse in ANCA-associated vasculitis. Ann Rheum Dis 2020; 79(9): 1243-9.
[http://dx.doi.org/10.1136/annrheumdis-2019-216863] [PMID: 32581088]
[63]
Ferraro AJ, Smith SW, Neil D, Savage COS. Relapsed Wegener’s granulomatosis after rituximab therapy--B cells are present in new pathological lesions despite persistent ‘depletion’ of peripheral blood. Nephrol Dial Transplant 2008; 23(9): 3030-2.
[http://dx.doi.org/10.1093/ndt/gfn318] [PMID: 18586761]
[64]
Venhoff N, Effelsberg NM, Salzer U, et al. Impact of rituximab on immunoglobulin concentrations and B cell numbers after cyclophosphamide treatment in patients with ANCA-associated vasculitides. PLoS One 2012; 7(5): e37626.
[http://dx.doi.org/10.1371/journal.pone.0037626] [PMID: 22629432]
[65]
Tsuboi K, Noguchi K, Kitano M, et al. Serum B cell activating factor (BAFF) as a biomarker for induction of remission with rituximab in ANCA-associated vasculitis. Immunol Med 2022; 45(4): 238-43.
[http://dx.doi.org/10.1080/25785826.2022.2094592] [PMID: 35802795]
[66]
Venhoff N, Niessen L, Kreuzaler M, et al. Reconstitution of the peripheral B lymphocyte compartment in patients with ANCA-associated vasculitides treated with rituximab for relapsing or refractory disease. Autoimmunity 2014; 47(6): 401-8.
[http://dx.doi.org/10.3109/08916934.2014.914174] [PMID: 24798501]
[67]
Springer JM, Funk RS. Dose-dependent pharmacological response to rituximab in the treatment of antineutrophil cytoplasmic antibody-associated vasculitis. J Rheumatol 2021; 48(11): 1718-24.
[http://dx.doi.org/10.3899/jrheum.210361] [PMID: 34334366]
[68]
Diegues A, Tavares J, Sá D, et al. Granulomatosis with polyangiitis: Recurrence or treatment consequences? Eur J Case Rep Intern Med 2021; 8(4): 002448.
[PMID: 33987124]
[69]
van Dam LS, Oskam JM, Kamerling SWA, et al. Highly sensitive flow cytometric detection of residual B-cells after rituximab in anti-neutrophil cytoplasmic antibodies-associated vasculitis patients. Front Immunol 2020; 11: 566732.
[http://dx.doi.org/10.3389/fimmu.2020.566732] [PMID: 33384685]
[70]
Unizony S, Lim N, Phippard DJ, et al. Peripheral CD5+ B cells in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheumatol 2015; 67(2): 535-44.
[http://dx.doi.org/10.1002/art.38916] [PMID: 25332071]
[71]
Chocova Z, Hruskova Z, Mareckova H, et al. Rituximab use in patients with ANCA-associated vasculitis: Clinical efficacy and impact on immunological parameters. Clin Rheumatol 2015; 34(1): 107-15.
[http://dx.doi.org/10.1007/s10067-014-2816-7] [PMID: 25388644]
[72]
Martinez Valenzuela L, Bordignon Draibe J, Fulladosa Oliveras X, Bestard Matamoros O, Cruzado Garrit JM, Torras Ambrós J. T-lymphocyte in ANCA-associated vasculitis: What do we know? A pathophysiological and therapeutic approach. Clin Kidney J 2019; 12(4): 503-11.
[http://dx.doi.org/10.1093/ckj/sfz029] [PMID: 31384441]
[73]
Mélet J, Mulleman D, Goupille P, Ribourtout B, Watier H, Thibault G. Rituximab-induced T cell depletion in patients with rheumatoid arthritis: association with clinical response. Arthritis Rheum 2013; 65(11): 2783-90.
[http://dx.doi.org/10.1002/art.38107] [PMID: 23918413]
[74]
Besada E, Nossent JC. CD4 cell count and CD4/CD8 ratio increase during rituximab maintenance in Granulomatosis with polyangiitis patients. PeerJ 2016; 4: e2487.
[http://dx.doi.org/10.7717/peerj.2487] [PMID: 27688979]
[75]
Zhao Y, Lutalo PMK, Thomas JE, et al. Circulating T follicular helper cell and regulatory T cell frequencies are influenced by B cell depletion in patients with granulomatosis with polyangiitis. Rheumatology (Oxford) 2014; 53(4): 621-30.
[http://dx.doi.org/10.1093/rheumatology/ket406] [PMID: 24357812]
[76]
Merkt W, Claus M, Blank N, et al. Active but not inactive granulomatosis with polyangiitis is associated with decreased and phenotypically and functionally altered CD56dim natural killer cells. Arthritis Res Ther 2016; 18(1): 204.
[http://dx.doi.org/10.1186/s13075-016-1098-7] [PMID: 27624647]
[77]
Merkt W, Lorenz HM, Watzl C. Rituximab induces phenotypical and functional changes of NK cells in a non-malignant experimental setting. Arthritis Res Ther 2016; 18(1): 206.
[http://dx.doi.org/10.1186/s13075-016-1101-3] [PMID: 27629249]
[78]
Kishimoto T, Hibi M, Murakami M, Narazaki M, Saito M, Taga T. The molecular biology of interleukin 6 and its receptor. In: Bock GR, Marsh J, Widdows K, Eds. Ciba Foundation Symposium 167 - Polyfunctional Cytokines: IL-6 and LIF. 1992; pp. 5-16.
[79]
Wang Q, van Timmeren MM, Petersen AH, et al. Age-determined severity of anti-myeloperoxidase autoantibody-mediated glomerulonephritis in mice. Nephrol Dial Transplant 2017; 32(2): 254-64.
[PMID: 28186568]
[80]
Berti A, Warner R, Johnson K, et al. The association of serum interleukin-6 levels with clinical outcomes in antineutrophil cytoplasmic antibody-associated vasculitis. J Autoimmun 2019; 105: 102302.
[http://dx.doi.org/10.1016/j.jaut.2019.07.001] [PMID: 31320177]
[81]
Nataraja A, Mukhtyar C, Hellmich B, Langford C, Luqmani R. Outpatient assessment of systemic vasculitis. Best Pract Res Clin Rheumatol 2007; 21(4): 713-32.
[http://dx.doi.org/10.1016/j.berh.2007.01.004] [PMID: 17678832]
[82]
Boomsma MM, Stegeman CA, Van Der Leij MJ, et al. Prediction of relapses in Wegener’s granulomatosis by measurement of antineutrophil cytoplasmic antibody levels: A prospective study. Arthritis Rheum 2000; 43(9): 2025-33.
[PMID: 11014352]
[83]
Joshi L, Lightman SL, Salama AD, Shirodkar AL, Pusey CD, Taylor SRJ. Rituximab in refractory ophthalmic Wegener’s granulomatosis: PR3 titers may predict relapse, but repeat treatment can be effective. Ophthalmology 2011; 118(12): 2498-503.
[http://dx.doi.org/10.1016/j.ophtha.2011.06.009] [PMID: 21907416]
[84]
van Dam LS, Dirikgil E, Bredewold EW, et al. PR3-ANCAs predict relapses in ANCA-associated vasculitis patients after rituximab. Nephrol Dial Transplant 2021; 36(8): 1408-17.
[http://dx.doi.org/10.1093/ndt/gfaa066] [PMID: 32601673]
[85]
McClure ME, Wason J, Gopaluni S, et al. Evaluation of PR3-ANCA status after rituximab for ANCA-associated vasculitis. J Clin Rheumatol 2019; 25(5): 217-23.
[http://dx.doi.org/10.1097/RHU.0000000000001030] [PMID: 30896460]
[86]
Finkielman JD, Merkel PA, Schroeder D, et al. Antiproteinase 3 antineutrophil cytoplasmic antibodies and disease activity in Wegener granulomatosis. Ann Intern Med 2007; 147(9): 611-9.
[http://dx.doi.org/10.7326/0003-4819-147-9-200711060-00005] [PMID: 17975183]
[87]
Rasmussen N, Salmela A, Ekstrand A, et al. Changes in proteinase 3 anti-neutrophil cytoplasm autoantibody levels in early systemic granulomatosis with polyangiitis (Wegener’s) may reflect treatment rather than disease activity. Clin Exp Rheumatol 2013; 31(1): S38-44.
[PMID: 23380137]
[88]
Unizony S, Villarreal M, Miloslavsky EM, et al. Clinical outcomes of treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis based on ANCA type. Ann Rheum Dis 2016; 75(6): 1166-9.
[http://dx.doi.org/10.1136/annrheumdis-2015-208073] [PMID: 26621483]
[89]
Md Yusof MY, Vital EM, Das S, et al. Repeat cycles of rituximab on clinical relapse in ANCA-associated vasculitis: Identifying B cell biomarkers for relapse to guide retreatment decisions. Ann Rheum Dis 2015; 74(9): 1734-8.
[http://dx.doi.org/10.1136/annrheumdis-2014-206496] [PMID: 25854586]
[90]
Miyazaki Y, Nakayamada S, Kubo S, et al. Favorable efficacy of rituximab in ANCA-associated vasculitis patients with excessive B cell differentiation. Arthritis Res Ther 2020; 22(1): 141.
[http://dx.doi.org/10.1186/s13075-020-02215-x] [PMID: 32539843]
[91]
Bunch DO, Mendoza CE, Aybar LT, et al. Gleaning relapse risk from B cell phenotype: decreased CD5 + B cells portend a shorter time to relapse after B cell depletion in patients with ANCA-associated vasculitis. Ann Rheum Dis 2015; 74(9): 1784-6.
[http://dx.doi.org/10.1136/annrheumdis-2014-206756] [PMID: 25934841]
[92]
Nasrallah M, Pouliot Y, Hartmann B, et al. Reanalysis of the Rituximab in ANCA-Associated Vasculitis trial identifies granulocyte subsets as a novel early marker of successful treatment. Arthritis Res Ther 2015; 17(1): 262.
[http://dx.doi.org/10.1186/s13075-015-0778-z] [PMID: 26387933]
[93]
Pepper RJ, Draibe JB, Caplin B, et al. Association of serum calprotectin (S100A8/A9) level with disease relapse in proteinase 3–antineutrophil cytoplasmic antibody–associated vasculitis. Arthritis Rheumatol 2017; 69(1): 185-93.
[http://dx.doi.org/10.1002/art.39814] [PMID: 27428710]
[94]
Alberici F, Smith RM, Fonseca M, et al. Association of a TNFSF13B (BAFF) regulatory region single nucleotide polymorphism with response to rituximab in antineutrophil cytoplasmic antibody–associated vasculitis. J Allergy Clin Immunol 2017; 139(5): 1684-1687.e10.
[95]
Puchala M, Rydzewski A, Kowalik I, Wisłowska M. Comparison of granulomatosis with polyangiitis clinical features in patients depending on involvement or absence of kidney involvement. Curr Rheumatol Rev 2021; 17(4): 379-89.
[http://dx.doi.org/10.2174/1573397117666210726143757] [PMID: 34313202]
[96]
Durel CA, Hot A, Trefond L, et al. Orbital mass in ANCA-associated vasculitides: Data on clinical, biological, radiological and histological presentation, therapeutic management, and outcome from 59 patients. Rheumatology (Oxford) 2019; 58(9): 1565-73.
[http://dx.doi.org/10.1093/rheumatology/kez071] [PMID: 30887055]
[97]
Pullerits R, Ljevak M, Vikgren J, Bokarewa M. Off-trial evaluation of the B cell-targeting treatment in the refractory cases of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis: Long-term follow-up from a single centre. Scand J Immunol 2012; 76(4): 411-20.
[http://dx.doi.org/10.1111/j.1365-3083.2012.02747.x] [PMID: 22823472]
[98]
Owczarczyk K, Cascino MD, Holweg C, et al. Fc receptor-like 5 and anti-CD20 treatment response in granulomatosis with polyangiitis and microscopic polyangiitis. JCI Insight 2020; 5(18): e136180.
[http://dx.doi.org/10.1172/jci.insight.136180] [PMID: 32841219]
[99]
Draibe J, Salama AD. Association of ANCA associated vasculitis and rheumatoid arthritis: A lesser recognized overlap syndrome. Springerplus 2015; 4(1): 50.
[http://dx.doi.org/10.1186/s40064-015-0835-8] [PMID: 25664229]
[100]
Foray N, Hudali T, Papireddy M, Gao J. A case report describing a rare presentation of simultaneous occurrence of MPO-ANCA-associated vasculitis and rheumatoid arthritis. Case Rep Nephrol 2016; 2016: 1-5.
[http://dx.doi.org/10.1155/2016/9340524] [PMID: 27891268]
[101]
Itikyala S, Pattanaik D, Raza S. Systemic Lupus Erythematosus (SLE) and Antineutrophil Cytoplasmic Antibody-Associated Vasculitis (AAV) overlap syndrome: Case report and review of the literature. Case Rep Rheumatol 2019; 2019: 1-5.
[http://dx.doi.org/10.1155/2019/5013904] [PMID: 30723567]
[102]
Hounoki H, Shinoda K, Matsui A, et al. A Case of systemic lupus erythematosus and antineutrophil cytoplasmic antibodies-associated vasculitis overlap syndrome. Case Rep Rheumatol 2021; 2021: 1-6.
[http://dx.doi.org/10.1155/2021/6690658] [PMID: 33505756]
[103]
Farah RI, Shahin NA, Alawneh M, Adwan M. Rapidly progressive glomerulonephritis due to systemic lupus erythematosus and ANCA-associated vasculitis overlap. Lupus 2020; 29(8): 983-6.
[http://dx.doi.org/10.1177/0961203320920368] [PMID: 32316845]
[104]
Wu HHL, Wang CCY, Woywodt A, Ponnusamy A. Concurrent presentation of IgG4-related tubulointerstitial nephritis and ANCA MPO crescentic glomerulonephritis. Clin Nephrol Case Stud 2022; 10(1): 47-53.
[http://dx.doi.org/10.5414/CNCS110852] [PMID: 35837351]
[105]
Szilasi M, Mátyus J, File I, et al. Association of ANCA-associated vasculitis-rheumatoid arthritis overlap syndrome in four patients: Rituximab may be the right choice? Autoimmunity 2012; 45(4): 304-9.
[http://dx.doi.org/10.3109/08916934.2012.677078] [PMID: 22443800]
[106]
Huang J, Wu L, Huang X, et al. Successful treatment of dual-positive anti-myeloperoxidase and anti-glomerular basement membrane antibody vasculitis with pulmonary-renal syndrome. Case Rep Nephrol Dial 2016; 6(1): 1-7.
[http://dx.doi.org/10.1159/000443163] [PMID: 26889474]
[107]
Kant S, Shah AA, Hummers LK, Wigley FM, Geetha D. ANCA-associated vasculitis in scleroderma: A renal perspective
. Clin Nephrol 2018; 90(6): 413-8.
[http://dx.doi.org/10.5414/CN109445] [PMID: 30106367]
[108]
Pefanis A, Williams DS, Skrzypek H, Fung A, Paizis K. A case of ANCA-associated vasculitis presenting de novo in pregnancy, successfully treated with rituximab. Obstet Med 2020; 13(1): 41-4.
[http://dx.doi.org/10.1177/1753495X18780853] [PMID: 32284732]
[109]
Kant S, Morris A, Ravi S, et al. The impact of COVID-19 pandemic on patients with ANCA associated vasculitis. J Nephrol 2021; 34(1): 185-90.
[http://dx.doi.org/10.1007/s40620-020-00881-3] [PMID: 33034038]
[110]
Kataria S, Rogers S, Sadia H, et al. Antineutrophil Cytoplasmic Antibody (ANCA)-associated renal vasculitis after COVID-19 infection: A Case report. Cureus 2022; 14(6): e26111.
[http://dx.doi.org/10.7759/cureus.26111] [PMID: 35875289]
[111]
İnce B, Bektaş M, Koca N, et al. Antineutrophil cytoplasmic antibody-associated vasculitis and COVID-19. J Clin Rheumatol 2022; 28(6): 300-4.
[http://dx.doi.org/10.1097/RHU.0000000000001855] [PMID: 35612560]
[112]
FAI2R /SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors. Severity of COVID-19 and survival in patients with rheumatic and inflammatory diseases: Data from the French RMD COVID-19 cohort of 694 patients. Ann Rheum Dis 2021; 80(4): 527-38.
[http://dx.doi.org/10.1136/annrheumdis-2020-218310] [PMID: 33268442]
[113]
McClure ME, Zhu Y, Smith RM, et al. Long-term maintenance rituximab for ANCA-associated vasculitis: Relapse and infection prediction models. Rheumatology (Oxford) 2021; 60(3): 1491-501.
[http://dx.doi.org/10.1093/rheumatology/keaa541] [PMID: 33141217]
[114]
Schulze-Koops H, Krueger K, Vallbracht I, Hasseli R, Skapenko A. Increased risk for severe COVID-19 in patients with inflammatory rheumatic diseases treated with rituximab. Ann Rheum Dis 2021; 80(5): e67.
[http://dx.doi.org/10.1136/annrheumdis-2020-218075] [PMID: 32591357]
[115]
Tepasse PR, Hafezi W, Lutz M, et al. Persisting SARS-CoV-2 viraemia after rituximab therapy: Two cases with fatal outcome and a review of the literature. Br J Haematol 2020; 190(2): 185-8.
[http://dx.doi.org/10.1111/bjh.16896] [PMID: 32557623]
[116]
Strangfeld A, Schäfer M, Gianfrancesco MA, et al. Factors associated with COVID-19-related death in people with rheumatic diseases: Results from the COVID-19 Global Rheumatology Alliance physician-reported registry. Ann Rheum Dis 2021; 80(7): 930-42.
[http://dx.doi.org/10.1136/annrheumdis-2020-219498] [PMID: 33504483]
[117]
Haberman R, Axelrad J, Chen A, et al. Covid-19 in immune-mediated inflammatory diseases - Case series from New York. N Engl J Med 2020; 383(1): 85-8.
[http://dx.doi.org/10.1056/NEJMc2009567] [PMID: 32348641]
[118]
Combes AJ, Courau T, Kuhn NF, et al. Global absence and targeting of protective immune states in severe COVID-19. Nature 2021; 591(7848): 124-30.
[http://dx.doi.org/10.1038/s41586-021-03234-7] [PMID: 33494096]
[119]
Guilpain P, Le Bihan C, Foulongne V, et al. Rituximab for granulomatosis with polyangiitis in the pandemic of covid-19: Lessons from a case with severe pneumonia. Ann Rheum Dis 2021; 80(1): e10.
[http://dx.doi.org/10.1136/annrheumdis-2020-217549] [PMID: 32312768]
[120]
Fallet B, Kyburz D, Walker UA. Mild course of COVID-19 and spontaneous virus clearance in a patient with depleted peripheral blood B cells due to rituximab treatment. Arthritis Rheumatol 2020; 72(9): 1581-2.
[http://dx.doi.org/10.1002/art.41380] [PMID: 32458534]
[121]
Kopp CR, Naidu GSRSNK, Misra DP, et al. Managing ANCA-associated vasculitis during the COVID-19 pandemic: Results from an online survey. Rheumatol Int 2021; 41(11): 1941-7.
[http://dx.doi.org/10.1007/s00296-021-04975-4] [PMID: 34427760]
[122]
Watanabe T. Vasculitis following influenza vaccination: A review of the literature. Curr Rheumatol Rev 2017; 13(3): 188-96.
[PMID: 28521688]
[123]
Quartuccio L, Treppo E, Binutti M, Del Frate G, De Vita S. Timing of rituximab and immunoglobulin level influence the risk of death for COVID-19 in ANCA-associated vasculitis. Rheumatology (Oxford) 2021; 60(7): 3476-7.
[http://dx.doi.org/10.1093/rheumatology/keab175] [PMID: 33609106]
[124]
Shakoor MT, Birkenbach MP, Lynch M. ANCA-associated vasculitis following Pfizer-BioNTech COVID-19 vaccine. Am J Kidney Dis 2021; 78(4): 611-3.
[http://dx.doi.org/10.1053/j.ajkd.2021.06.016] [PMID: 34280507]
[125]
Villa M, Díaz-Crespo F, Pérez de José A, et al. A case of ANCA-associated vasculitis after AZD1222 (Oxford–AstraZeneca) SARS-CoV-2 vaccination: Casualty or causality? Kidney Int 2021; 100(4): 937-8.
[http://dx.doi.org/10.1016/j.kint.2021.07.026] [PMID: 34416184]
[126]
Chen CC, Chen HY, Lu CC, Lin SH. Case Report: Anti-neutrophil cytoplasmic antibody-associated vasculitis with acute renal failure and pulmonary hemorrhage may occur after COVID-19 vaccination. Front Med (Lausanne) 2021; 8(2195): 765447.
[http://dx.doi.org/10.3389/fmed.2021.765447] [PMID: 34859017]
[127]
Moor MB, Suter-Riniker F, Horn MP, et al. Humoral and cellular responses to mRNA vaccines against SARS-CoV-2 in patients with a history of CD20 B-cell-depleting therapy (RituxiVac): An investigator-initiated, single-centre, open-label study. Lancet Rheumatol 2021; 3(11): e789-97.
[http://dx.doi.org/10.1016/S2665-9913(21)00251-4] [PMID: 34514436]
[128]
Windpessl M, Bruchfeld A, Anders HJ, et al. COVID-19 vaccines and kidney disease. Nat Rev Nephrol 2021; 17(5): 291-3.
[http://dx.doi.org/10.1038/s41581-021-00406-6] [PMID: 33558753]
[129]
Choi B, Choudhary MC, Regan J, et al. Persistence and evolution of SARS-CoV-2 in an immunocompromised host. N Engl J Med 2020; 383(23): 2291-3.
[http://dx.doi.org/10.1056/NEJMc2031364] [PMID: 33176080]
[130]
Friedman MA, Winthrop KL. Second COVID-19 infection in a patient with granulomatosis with polyangiitis on rituximab. Ann Rheum Dis 2021; 80(8): 1102-4.
[http://dx.doi.org/10.1136/annrheumdis-2021-220088] [PMID: 33674264]
[131]
Friedman MA, Winthrop KL. Vaccines and disease-modifying antirheumatic drugs. Rheum Dis Clin North Am 2017; 43(1): 1-13.
[http://dx.doi.org/10.1016/j.rdc.2016.09.003] [PMID: 27890167]
[132]
Bruchfeld A, Kronbichler A, Alberici F, et al. COVID-19 and ANCA-associated vasculitis: Recommendations for vaccine preparedness and the use of rituximab. Nephrol Dial Transplant 2021; 36(9): 1758-60.
[http://dx.doi.org/10.1093/ndt/gfab174] [PMID: 33944946]
[133]
Kant S, Azar A, Geetha D. Antibody response to COVID-19 booster vaccine in rituximab-treated patients with anti-neutrophil cytoplasmic antibody-associated vasculitis. Kidney Int 2021.
[http://dx.doi.org/10.1016/j.kint.2021.08.020] [PMID: 34822874]
[134]
Pozzetto B, Legros V, Djebali S, et al. Immunogenicity and efficacy of heterologous ChAdOx1–BNT162b2 vaccination. Nature 2021; 600(7890): 701-6.
[http://dx.doi.org/10.1038/s41586-021-04120-y] [PMID: 34673755]
[135]
van Daalen EE, Rizzo R, Kronbichler A, et al. Effect of rituximab on malignancy risk in patients with ANCA-associated vasculitis. Ann Rheum Dis 2017; 76(6): 1064-9.
[http://dx.doi.org/10.1136/annrheumdis-2016-209925] [PMID: 27899372]
[136]
Flossmann O, Berden A, de Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 2011; 70(3): 488-94.
[http://dx.doi.org/10.1136/ard.2010.137778] [PMID: 21109517]

Rights & Permissions Print Cite
Article Metrics
18
1
Wayfinder Image
TIMBC 2025
© 2025 Bentham Science Publishers | Privacy Policy