Evidence map›Paper›PMID 28508096›Full record

Observational studyZeitschrift fur Rheumatologie2018

[Off-label biologic therapy of ANCA-associated and non-ANCA-associated small-vessel vasculitis : Efficacy and safety analysis of a national registry (GRAID2)].

N Venhoff, F Proft, H Schulze-Koops, J Holle, R E Voll, C Iking-Konert, A M Jacobi, J Henes, L Unger, O Kneitz and 2 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Zeitschrift fur Rheumatologie, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 10 institutions in 1 country.

N VenhoffVaskulitiszentrum Freiburg, Klinik für Rheumatologie und Klinische Immunologie, Department Innere Medizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hugstetterstraße 55, 79106, Freiburg, Deutschland.
F ProftSektion Rheumatologie und Klinische Immunologie, Medizinische Klinik IV, Klinikum der Universität München, München, Deutschland.
H Schulze-KoopsSektion Rheumatologie und Klinische Immunologie, Medizinische Klinik IV, Klinikum der Universität München, München, Deutschland.
J HolleKlinik für Rheumatologie und Immunologie, Klinikum Bad Bramstedt, Bad Bramstedt, Deutschland.
R E VollVaskulitiszentrum Freiburg, Klinik für Rheumatologie und Klinische Immunologie, Department Innere Medizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hugstetterstraße 55, 79106, Freiburg, Deutschland.
C Iking-KonertKlinik für Nephrologie und Rheumatologie, Med. Klinik III, Universitätsklinik Hamburg Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
A M JacobiMedizinische Klinik B, Ruppiner Kliniken, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Deutschland.
J HenesAbteilung für Onkologie, Hämatologie, klinische Immunologie, Rheumatologie, Pulmologie, Medizinische Klinik, Universität Tübingen, Tübingen, Deutschland.
L UngerDepartment Medizin I, Dresden Friedrichstadt Hospital, University Clinical Center Carl Gustav Carus, Schwerpunktpraxis Rheumatologie, Technische Universität Dresden, Dresden, Deutschland.
O KneitzKlinik für Innere Medizin II, Rheumatologie und klinische Immunologie, Klinikum Südstadt Rostock, Rostock, Deutschland.
T DörnerMedizinische Klinik m. S. Rheumatologie und klinische Immunologie, Charité Universitätsmedizin Berlin und DRFZ Berlin, Berlin, Deutschland.
J ThielVaskulitiszentrum Freiburg, Klinik für Rheumatologie und Klinische Immunologie, Department Innere Medizin, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Hugstetterstraße 55, 79106, Freiburg, Deutschland. jens.thiel@uniklinik-freiburg.de.
LMU Klinikum · DEUniversity Medical Center Freiburg · DECharité - Universitätsmedizin Berlin · DEHNO Bad Bramstedt · DEKlinikum Südstadt Rostock · DEMedizinische Hochschule Brandenburg Theodor Fontane · DEUniversität Hamburg · DEUniversity Hospital Carl Gustav Carus · DEUniversity of Freiburg · DEUniversity of Tübingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the clinical efficacy and safety of off-label biological therapies in patients with ANCA-associated vasculitis (AAV) and non-ANCA-associated small-vessel vasculitis (nAAV) in clinical practice.

methodsThe German Registry in Autoimmune Diseases 2 (GRAID2) is a national, retrospective, non-interventional, multicentre observational study (August 2006 until December 2013) on patients with autoimmune diseases refractory to standard immunosuppressive therapy treated with off-label biologicals.

resultsData from 64 patients (20.6% of all GRAID2 patients) were collected: 54 patients (84.4%) had ANCA-associated vasculitis (AAV) and 10 patients (15.6%) had non-ANCA-associated small-vessel vasculitis (nAAV). Of the AAV patients, 96.3% were treated off-label with rituximab (RTX) and 3.7% with tumor necrosis factor alpha (TNFα)-inhibitors. Of patients with nAAV, 30% were treated with RTX, 60% with TNFα-inhibitors, and 10% with tocilizumab. The main reasons for off-label biological treatment in AAV patients were pulmonary, renal, or ear, nose, and throat involvement. These manifestations clearly improved in most patients after off-label biological therapy was initiated. Daily glucocorticoid dosage could be reduced. The off-label biological therapy was generally well tolerated. In AAV patients, 4.18 severe infections per 100 patient years were observed. There was one death in the nAAV group caused by fungal infection and ileus. A correlation between this fatality and RTX treatment was regarded as possible.

conclusionSafety and efficacy of off-label RTX-treatment in AAV-patients could be assessed in the GRAID2 data. Results point to good efficacy and safety of RTX in this special patient cohort and support the approval of RTX for AAV induction therapy.

Indexed as

Antibodies, Antineutrophil CytoplasmicAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisBiological TherapyOff-Label UseHumansRegistriesRetrospective StudiesRituximabAntibodies, Antineutrophil CytoplasmicRituximabANCABiologicalsGRAIDOff-labelSmall-vessel vasculitis

Identifiers

PMID28508096
OpenAlexW2615465104

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.