EFFICACY OF INDUCTION TREATMENT WITH CYCLOPHOSPHAMIDE, RITUXIMAB AND THEIR COMBINATION IN PATIENTS WITH PAUCIIMMUNE VASCULITIS

Introduction:

Pauciimmune vasculitis has an adverse renal prognosis, even endangering the life of those who suffer from it, so it is important to know the effectiveness of its treatments. The present study aims to compare the response to induction treatment with cyclophosphamide, rituximab and their combination in patients with pauciimmune renal vasculitis.

Methods:

Retrospective cohort study with data between April 2018 and April 2024. Patients with a diagnosis of pauciimmune renal vasculitis who received treatment with cyclophosphamide, Rituximab or their combination with follow-up ≥ 26 weeks were included. Clinical characteristics prior to treatment initiation were assessed, as well as outcomes at 26 and 52 weeks.

Results:

Twenty-one patients were included: 9 (42.9%) treated with cyclophosphamide; 6 (28.6%) with rituximab and 6 (28.6%) with the combination of cyclophosphamide plus rituximab. The prevalence of antibodies was: 12 (57.1%) cases with anti-myeloperoxidase, 7 (33.3%) with anti-proteinase 3 and 2 (9.5%) were seronegative. Patients who received cyclophosphamide plus rituximab had a lower estimated glomerular filtration rate (eGFR) at start of treatment, in addition to being the group with more patients who required renal replacement therapy. [Table 1] At 26 weeks from the start of treatment, those who received rituximab had the lowest eGFR on average [Table 2]. At 52 weeks, worse renal outcomes occurred in the rituximab group (death, requirement for RRT, or severe deterioration of renal function) [Figure 1].    

Conclusions:

At 52 weeks, although without statistical difference, the efficacy in maintaining patients without severe renal function deterioration, free of renal replacement therapy and mortality was better with cyclophosphamide alone or cyclophosphamide plus rituximab schemes compared to those receiving rituximab alone.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.