Evidence map›Paper›PMID 31586310›Full record

Trial reportClinical pharmacokinetics2020

Non-Linear Rituximab Pharmacokinetics and Complex Relationship between Rituximab Concentrations and Anti-Neutrophil Cytoplasmic Antibodies (ANCA) in ANCA-Associated Vasculitis: The RAVE Trial Revisited.

Amina Bensalem, Denis Mulleman, Gilles Paintaud, Nicolas Azzopardi, Valérie Gouilleux-Gruart, Divi Cornec, Ulrich Specks, David Ternant

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Clinical pharmacokinetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 20% 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

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
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  6. Antibody Drug Clearance: An Underexplored Marker of Outcomes with Checkpoint Inhibitors.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024
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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

8 authors at 2 institutions in 2 countries.

Amina BensalemUniversité de Tours, EA 7501 GICC, Tours, France.
Denis MullemanUniversité de Tours, EA 7501 GICC, Tours, France.
Gilles PaintaudUniversité de Tours, EA 7501 GICC, Tours, France.
Nicolas AzzopardiUniversité de Tours, EA 7501 GICC, Tours, France.
Valérie Gouilleux-GruartUniversité de Tours, EA 7501 GICC, Tours, France.
Divi CornecDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
Ulrich SpecksDivision of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.
David TernantUniversité de Tours, EA 7501 GICC, Tours, France. david.ternant@univ-tours.fr.ORCID http://orcid.org/0000-0003-4020-4545
Université de Tours · FRMayo Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesRituximab is approved in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and leads to a decrease of ANCA levels. The objectives of this study were to investigate the non-linear pharmacokinetics of rituximab and the relationship between its concentrations and ANCA levels in AAV patients.

methodsNinety-two AAV patients from the RAVE (Rituximab in ANCA-Associated Vasculitis) trial were assessed. Both ANCA anti-myeloperoxidase (MPO-ANCA) and anti-proteinase 3 (PR3-ANCA) levels were used as biomarkers. The pharmacokinetics of rituximab were described using a semi-mechanistic two-compartment model that included a latent target antigen turnover and allowed the estimation of specific target-mediated elimination in addition to its non-specific elimination of rituximab. The effect of rituximab on the ANCA level was described using a semi-mechanistic compartment model with a negative feedback (Friberg) model with no transit compartment. A population modeling approach was used.

resultsOur pharmacokinetic and pharmacokinetic-pharmacodynamic (PK-PD) models satisfactorily described both concentration-time and concentration-effect relationship data. The mean (inter-individual standard deviation) estimated non-specific clearance was 0.15 L/day (0.30%) and the target-mediated elimination rate constant was 2.4 × 10

conclusionsA non-linear target-mediated elimination of rituximab was detected in AAV patients. Our PK-PD model allowed quantification of the association between rituximab concentrations and ANCA levels. This decrease was deep but delayed, and more sustained in patients with MPO-ANCA than in those with PR3-ANCA. Our results suggest that repeating courses of rituximab might improve the clinical response to rituximab.

Indexed as

AdultAgedAged, 80 and overAntibodies, Antineutrophil CytoplasmicAntineoplastic Agents, ImmunologicalAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisBiomarkersDouble-Blind MethodFemaleHumansInfusions, IntravenousMaleMiddle AgedModels, BiologicalMyeloblastinNonlinear DynamicsAntibodies, Antineutrophil CytoplasmicAntineoplastic Agents, ImmunologicalBiomarkersMyeloblastinPeroxidaseRituximab

Identifiers

PMID31586310
OpenAlexW2978143927

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.