Most Read Articles
22 hours ago
There appears to be a high rate of emergency department (ED) admission for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), with patients having significant in-hospital mortality, according to data from the *AANZDEM study. Furthermore, compliance with evidence-based treatments in the ED is suboptimal.
Tristan Manalac, 5 days ago
Of the newly identified genetic loci for primary angle-closure glaucoma (PACG), two are significantly associated with primary angle-closure suspect (PACS), indicating involvement in the earlier stages of the disease, a recent Singapore study has shown.
2 days ago
Resistance training appears to confer significant benefits for inflammation and insulin pathway profiles in postmenopausal breast cancer survivors, according to a study. However, the magnitude and degree of benefit from exercise may be influenced by whether or not women gained strength and/or lost weight during exercise.
Pearl Toh, 2 days ago
Patients with inflammatory bowel disease (IBD) who had primary nonresponse to an anti-tumour necrosis factor (TNF) agent ─ or inadequate response to the initial loading doses ─ were less likely to respond to second-line biologics compared with those who had secondary loss of response (LOR) or intolerance to the primary therapy, according to a systematic review and meta-analysis presented at the Crohn's & Colitis Congress (CCC) 2018 held recently in Las Vegas, Nevada, US.

Rituximab may induce remission, allow glucocorticoid tapering in IgAV

06 Dec 2017

Rituximab appears to be safe and effective in the treatment of patients with adult-onset IgA vasculitis (IgAV), inducing disease remission and allowing glucocorticoid tapering, according to a study.

The multicentre, observational study included 22 patients with adult-onset IgAV (formerly Henoch-Schönlein purpura) who had received rituximab for either refractory/relapsing disease or due to contraindications to conventional glucocorticoid/immunosuppressive therapy. The median follow-up was 24 months.

Researchers estimated the rates of remission (defined on the basis of the Birmingham Vasculitis Activity Score, BVAS) and relapse, as well as the variations over time in estimated glomerular filtration rate (eGFR), proteinuria, C-reactive protein levels, BVAS and prednisone dose.

Rituximab was given to 16 patients as add-on therapy and to six as monotherapy. Overall, 20 (90.9 percent) achieved remission and seven (35 percent) subsequently relapsed. Rituximab treatment led to a significant reduction in 24 hour-proteinuria (p<0.0001), C-reactive protein (p=0.0005), BVAS (p<0.0001) and prednisone dose (p<0.0001). Moreover, eGFR remained stable.

In terms of safety, treatment was well tolerated. There was one patient who died after 60 months of follow-up.

Researchers noted that while the use of rituximab in IgAV may potentially reduce the proliferation of IgA-producing plasma cells or deplete tissue-infiltrating B-cells, “its therapeutic efficacy most likely results from the impairment of other B-cell functions such as antigen-presentation and T-cell costimulation, as already postulated in ANCA-associated vasculitis and other autoimmune conditions.” [Nephrol Dial Transplant 2013;29:1151–59]

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Most Read Articles
22 hours ago
There appears to be a high rate of emergency department (ED) admission for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), with patients having significant in-hospital mortality, according to data from the *AANZDEM study. Furthermore, compliance with evidence-based treatments in the ED is suboptimal.
Tristan Manalac, 5 days ago
Of the newly identified genetic loci for primary angle-closure glaucoma (PACG), two are significantly associated with primary angle-closure suspect (PACS), indicating involvement in the earlier stages of the disease, a recent Singapore study has shown.
2 days ago
Resistance training appears to confer significant benefits for inflammation and insulin pathway profiles in postmenopausal breast cancer survivors, according to a study. However, the magnitude and degree of benefit from exercise may be influenced by whether or not women gained strength and/or lost weight during exercise.
Pearl Toh, 2 days ago
Patients with inflammatory bowel disease (IBD) who had primary nonresponse to an anti-tumour necrosis factor (TNF) agent ─ or inadequate response to the initial loading doses ─ were less likely to respond to second-line biologics compared with those who had secondary loss of response (LOR) or intolerance to the primary therapy, according to a systematic review and meta-analysis presented at the Crohn's & Colitis Congress (CCC) 2018 held recently in Las Vegas, Nevada, US.