Effectiveness and safety of rituximab for remission maintenance therapy in microscopic polyangiitis and granulomatosis with polyangiitis in Japan: A retrospective multicentre cohort study (J-CANVAS).
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Takeuchi Motoki, Abe Yoshiyuki, Makiyama Ayako, Kogami Masahiro, Omura Satoshi, Nakagomi Daiki, Kadoya Masatoshi, Takizawa Naoho, Nomura Atsushi, Kukida Yuji, Kondo Naoya, Yamano Yasuhiko, Yanagida Takuya, Endo Koji, Hirata Shintaro, Matsui Kiyoshi, Takeuchi Tohru, Ichinose Kunihiro, Yanai Ryo, Matsuo Yusuke, Shimojima Yasuhiro, Nishioka Ryo, Okazaki Ryota, Takata Tomoaki, Ito Takafumi, Moriyama Mayuko, Takatani Ayuko, Miyawaki Yoshia, Kawahito Yutaka, Ito-Ihara Toshiko, Kida Takashi, Yajima Nobuyuki, Kawaguchi Takashi, Yamaji Ken, Tamura Naoto
Аннотация
METHODS: Japanese patients with MPA or granulomatosis with polyangiitis (GPA) enrolled in a nationwide registry were included. Exposure was RTX use during maintenance therapy. The primary endpoint was major relapse-free survival at 104 weeks. The secondary endpoint was any relapse-free survival (major or minor) at 104 weeks. Baseline differences were adjusted using inverse probability of treatment weighting based on key demographic and disease-related covariates.
RESULTS: A total of 389 patients were analysed, with 85 in the RTX group. The RTX group included a higher proportion of GPA cases (37/85 vs. 74/304), resulting in baseline imbalance. After inverse probability of treatment weighting, no major relapses were observed in the RTX group, whereas the major relapse-free survival at 104 weeks was 94.8% in the non-RTX group. The RTX group showed significantly higher any relapse-free survival at 104 weeks (95.4% versus 83.3%; HR for any relapse, 0.27; 95% CI, 0.09-0.74; P = .02).
CONCLUSIONS: Our findings suggest that RTX may be an effective option for remission maintenance in Japanese patients with MPA or GPA.