Is rituximab effective for induction of remission in ANCA-associated vasculitis?

Abstract

Adding rituximab to the treatment with corticosteroids has been proposed as a therapeutic alternative for inducing remission in anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, especially when fertility is a concern, or when there is contraindication or intolerance to cyclophosphamide. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified only one systematic review including three pertinent randomized controlled trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded rituximab may slightly increase induction of remission rate, but it may also increase the risk of infection. It is not clear whether it increases the risk of cancer, or whether increases or decreases mortality because the certainty of the evidence is very low.

• Authors: Carmen Rain, Tatiana Yáñez, Gabriel Rada
• Journal: Medwave (Medwave) Vol. 15 Suppl 2 Pg. e6209 (Aug 13 2015) ISSN: 0717-6384 [Electronic] Chile
• PMID: 26335502 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Adrenal Cortex Hormones
• Immunologic Factors
• Rituximab

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis (drug therapy, mortality)
• Drug Therapy, Combination
• Humans
• Immunologic Factors (administration & dosage, adverse effects, therapeutic use)
• Randomized Controlled Trials as Topic
• Remission Induction (methods)
• Rituximab (administration & dosage, adverse effects, therapeutic use)