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Topics:
Internal Medicine • Rheumatology • Vasculitis • ANCA Vasculitis • Pulmonology • ACR 2024 • Continue the Conversation
How long do you continue rituximab in patients with ANCA associated vasculitis who have achieved remission?
What information do you use to make this determination? Do you tend to transition to an oral agent like azathioprine after discontinuation to prevent relapse?
This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeting. This question was inspired by the session "Controversies in the Treatment of ANCA-associated Vasculitis" by Dr. @Carol Langford and Dr. @Philip Seo.
Answer from: at Academic Institution
My approach is to use rituximab every 6 months for remission maintenance for at least 2 years. Past that point, a lot depends on the individual patient circumstances. For patients who have already suffered substantial organ damage, for whom another flare could be catastrophic (e.g., a patient with s...
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Answer from: at Academic Institution
After remission induction of active disease with rituximab, I recommend remission maintenance therapy in almost all patients, given the high frequency of relapse in ANCA associated vasculitis. In shared decision-making with the patient, I discuss the options of rituximab or a conventional immunosupp...