Abstract | BACKGROUND: OBJECTIVES: To investigate the efficacy and safety of RTX and conventional immunosuppressive therapy with CYC in EGPA as induction therapy and during long-term follow-up. METHODS: RESULTS: Fourteen patients with EGPA treated with RTX were compared with 14 age- and sex-matched patients with EGPA treated with CYC for remission induction; 64% of the RTX-treated patients with EGPA had previously failed CYC treatment. Disease duration was longer and the number of previous immunosuppressants higher in RTX-treated patients. Five RTX-treated patients (36%) and 4 CYC-treated patients (29%) achieved complete remission. All other patients were in partial remission. There was no difference between both groups in respect to treatment response and partial and complete remission. In both treatment groups, eosinophils, C-reactive protein, and IgE levels dropped. Relapse-free survival within an observation period of 36 months was comparable between RTX- and CYC-treated patients. RTX was well tolerated, but resulted in a decline in serum immunoglobulin levels. CONCLUSIONS: RTX was effective in inducing remission and during long-term follow-up in patients with EGPA, even when previously refractory to standard immunosuppressive therapy including CYC. RTX-treated patients should be monitored for hypogammaglobulinemia.
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Authors | Jens Thiel, Arianna Troilo, Ulrich Salzer, Theresa Schleyer, Kirsten Halmschlag, Marta Rizzi, Natalie Frede, Ana Venhoff, Reinhard E Voll, Nils Venhoff |
Journal | The journal of allergy and clinical immunology. In practice
(J Allergy Clin Immunol Pract)
2017 Nov - Dec
Vol. 5
Issue 6
Pg. 1556-1563
ISSN: 2213-2201 [Electronic] United States |
PMID | 28916432
(Publication Type: Journal Article)
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Copyright | Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Antibodies, Antineutrophil Cytoplasmic
- Immunosuppressive Agents
- Rituximab
- Cyclophosphamide
- C-Reactive Protein
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Topics |
- Adult
- Antibodies, Antineutrophil Cytoplasmic
(metabolism)
- B-Lymphocytes
(immunology)
- C-Reactive Protein
(metabolism)
- Churg-Strauss Syndrome
(drug therapy)
- Cyclophosphamide
(therapeutic use)
- Drug Therapy, Combination
- Eosinophils
(immunology)
- Female
- Follow-Up Studies
- Granulomatosis with Polyangiitis
(drug therapy)
- Humans
- Immunosuppressive Agents
(therapeutic use)
- Male
- Middle Aged
- Retrospective Studies
- Rituximab
(therapeutic use)
- Treatment Outcome
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