1. Long-term efficacy of remission-maintenance regimens for ANCA-associated vasculitides
- Author
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Olivier Aumaître, Olivier Lidove, Chahéra Khouatra, Olivier Decaux, Pascal Cohen, P. Gobert, Claire Blanchard-Delaunay, Philippe Ravaud, Pascal Godmer, Xavier Puéchal, Mohamed Hamidou, Hélène Desmurs-Clavel, Pierre-Louis Carron, Elodie Perrodeau, Marize Ducret, Bernard Bonnotte, Thomas Quemeneur, Christian Pagnoux, François Maurier, Benjamin Terrier, Eric Daugas, Luc Mouthon, Nicolas Limal, Loïc Guillevin, A. Karras, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Clermont-Ferrand, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Valenciennes, Santé - STIC, Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Grenoble, Immunopathologie rénale, récepteurs et inflammation, Centre hospitalier universitaire de Nantes (CHU Nantes), Université Paris Descartes - Paris 5 (UPD5), Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Hospices Civils de Lyon ( HCL ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Université Paris Descartes - Paris 5 ( UPD5 ), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
- Subjects
Male ,Azathioprine ,Kaplan-Meier Estimate ,urologic and male genital diseases ,Gastroenterology ,Severity of Illness Index ,0302 clinical medicine ,immune system diseases ,Recurrence ,Risk Factors ,Clinical endpoint ,Immunology and Allergy ,030212 general & internal medicine ,skin and connective tissue diseases ,treatment ,Remission Induction ,Middle Aged ,3. Good health ,Treatment Outcome ,Antirheumatic Agents ,Rituximab ,Female ,systemic vasculitis ,Granulomatosis with polyangiitis ,Microscopic polyangiitis ,Vasculitis ,Immunosuppressive Agents ,medicine.drug ,Systemic vasculitis ,Adult ,medicine.medical_specialty ,Immunology ,Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ,General Biochemistry, Genetics and Molecular Biology ,Drug Administration Schedule ,Antibodies, Antineutrophil Cytoplasmic ,03 medical and health sciences ,Rheumatology ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Lymphocyte Count ,Glucocorticoids ,Anti-neutrophil cytoplasmic antibody ,Aged ,030203 arthritis & rheumatology ,[SDV.GEN]Life Sciences [q-bio]/Genetics ,granulomatosis with polyangiitis ,Dose-Response Relationship, Drug ,business.industry ,medicine.disease ,respiratory tract diseases ,[ SDV.GEN ] Life Sciences [q-bio]/Genetics ,business - Abstract
International audience; Objective - To compare long-term efficacy of remission-maintenance regimens in patients with newly diagnosed or relapsing antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides. Methods - The 28-month Maintenance of Remission using Rituximab in Systemic ANCA-associated Vasculitis trial compared rituximab with azathioprine to maintain remission in patients with newly diagnosed or relapsing granulomatosis with polyangiitis, microscopic polyangiitis or renal-limited ANCA-associated vasculitis. Thereafter, prospective patient follow-up lasted until month 60. The primary endpoint was the major-relapse rate at month 60. Relapse and serious adverse event-free survival were also assessed. Results - Among the 115 enrolled patients, only one was lost to follow-up at month 60. For the azathioprine and rituximab groups, respectively, at month 60, the major relapse-free survival rates were 49.4% (95% CI 38.0% to 64.3%) and 71.9% (95% CI 61.2% to 84.6%) (p=0.003); minor and major relapse-free survival rates were 37.2% (95% CI 26.5% to 52.2%) and 57.9% (95% CI 46.4% to 72.2%) (p=0.012); overall survival rates were 93.0% (95% CI 86.7% to 99.9%) and 100% (p=0.045) and cumulative glucocorticoid use was comparable. Quality-adjusted time without symptoms and toxicity analysis showed that rituximab-treated patients had 12.6 months more without relapse or toxicity than those given azathioprine (p
- Published
- 2017
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