Evidence map›Paper›PMID 32581088›Full record

Observational studyAnnals of the rheumatic diseases2020

Rituximab as therapy to induce remission after relapse in ANCA-associated vasculitis.

Rona M Smith, Rachel Bronwen Jones, Ulrich Specks, Simon Bond, Marianna Nodale, Reem Aljayyousi, Jacqueline Andrews, Annette Bruchfeld, Brian Camilleri, Simon Carette and 38 more

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Annals of the rheumatic diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
90citing papers in PubMed, 3 pooled it
14.7field-weighted citation impact, top 1% 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

90 citing papers in PubMed, 3 syntheses or guidelines pooled it, 169 citations in OpenAlex.

  1. [Diagnosis and treatment of ANCA-associated vasculitis : SHORT VERSION of the S3 guideline of the German Society for Rheumatology and Clinical Immunology e. V. (DGRh) and German Society for Internal Medicine e. V. (DGIM), German Society for Nephrology e. V. (DGfN), German Society for Otorhinolaryngology and Head and Neck Surgery e. V. (DGHNO-KHC), German Ophthalmological Society e. V. (DOG), German Society for Neurology e. V. (DGN), German Society for Pneumology and Respiratory Medicine e. V. (DGP), German Society for Pathology e. V. (DGP), German Radiological Society, Society for Medical Radiology e. V. (DRG), Federal Association of German Pathologists, Federal Kidney Association e. V., German Rheumatism League Federal Association e. V.]Zeitschrift fur Rheumatologie · 2025
    Guideline
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30 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

48 authors at 20 institutions in 7 countries.

Rona M SmithUniversity of Cambridge, Cambridge, UK ronasmith@doctors.net.uk.ORCID 0000-0002-7438-5156
Rachel Bronwen JonesCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID 0000-0003-4790-283X
Ulrich SpecksMayo Clinic, Rochester, Minnesota, USA.
Simon BondCambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Marianna NodaleCambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.ORCID 0000-0002-0333-8918
Reem AljayyousiUniversity Hospitals of Leicester NHS Trust, Leicester, Leicester, UK.
Jacqueline AndrewsNIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust, Leeds, UK.
Annette BruchfeldDepartment of Renal Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden.
Brian CamilleriIpswich Hospital NHS Trust, Ipswich, UK.
Simon CaretteUniversity of Toronto, Toronto, Ontario, Canada.
Chee Kay CheungUniversity of Leicester, Leicester, UK.
Vimal DerebailUniversity of North Carolina, Chapel Hill, North Carolina, USA.
Tim DoultonEast Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK.
Lindsy ForbessCedars-Sinai Medical Center, Los Angeles, California, USA.
Shouichi FujimotoUniversity of Miyazaki, Miyazaki, Japan.
Shunsuke FurutaChiba University, Chiba, Japan.
Ora Gewurz-SingerUniversity of Michigan, Ann Arbor, Michigan, USA.
Lorraine HarperUniversity of Birmingham, Birmingham, UK.ORCID 0000-0003-1343-9234
Toshiko Ito-IharaKyoto University, Kyoto, Japan.
Nader KhalidiMcMaster University, Hamilton, Ontario, Canada.
Rainer KlockeDudley Group NHS Foundation Trust, Dudley, West Midlands, UK.
Curry KoeningUniversity of Utah Vasculitis Center, Salt Lake City, Utah, USA.
Yoshinori KomagataKyorin University School of Medicine, Tokyo, Japan.
Carol LangfordCleveland Clinic Foundation, Cleveland, Ohio, USA.
Peter LanyonRheumatology, Nottingham University Hospital, Nottingham, UK.
Raashid Ahmed LuqmaniNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science (NDORMs), University of Oxford, Oxford, UK.
Hirofumi MakinoOkayama Universty Hospital, Okayama, Japan.
Carole A McAlearDivision of Rheumatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Paul MonachDivision of Rheumatology, VA Boston Healthcare System, West Roxbury, Massachusetts, USA.
Larry W MorelandUniversity of Pittsburg, Pittsburg, Pennsylvania, USA.
Kim MynardCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Patrick NachmanUniversity of North Carolina, Chapel Hill, North Carolina, USA.
Christian PagnouxMount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Fiona PearceNottingham University Hospitals NHS Trust, Nottingham, Nottingham, UK.
Chen Au PehRoyal Adelaide Hospital, Adelaide, South Australia, Australia.
Charles PuseyImperial College London, London, UK.
Dwarakanathan RanganathanRoyal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Rennie L RheePerelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.ORCID 0000-0002-4907-0304
Robert SpieraHSS, New York, New York, USA.
Antoine G SreihUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Vladimir TesarDepartment of Nephrology, Charles University, Prague, Czech Republic.
Giles WaltersCanberra Hospital, Canberra, Australian Capital Territory, Australia.ORCID 0000-0003-4854-9353
Michael H WeismanCedars-Sinai Medical Center, Los Angeles, California, USA.
Caroline WroeSouth Tees Hospitals NHS Foundation Trust, Middlesbrough, Middlesbrough, UK.
Peter A MerkelUniversity of Pennsylvania, Philadelphia, Pennsylvania, USA.
David JayneUniversity of Cambridge, Cambridge, UK.
RITAZAREM coinvestigators
RITAZAREM co-investigators
Cambridge University Hospitals NHS Foundation Trust · GBUniversity of Pennsylvania · USCedars-Sinai Medical Center · USUniversity of Cambridge · GBUniversity of North Carolina at Chapel Hill · USCanberra Hospital · AUCharles University · CZChiba University · JPCleveland Clinic · USDudley Group NHS Foundation Trust · GBEast Kent Hospitals University NHS Foundation Trust · GBHudson Simulation Service · USImperial College London · GBIpswich Hospital · GBKarolinska University Hospital · SEKyorin University · JPKyoto University · JPMayo Clinic · USMcMaster University · CAMount Sinai Hospital · CA

Funding

VCRC-VF FellowshipU54AR057319 · NIAMS · UNIVERSITY OF PENNSYLVANIA · PI MERKEL, PETER A · 2009 to 2020
$12.5M
VASCULITIS CLINICAL RESEARCH NETWORK (VCRN): RARE DISEASEU54RR019497 · NCRR · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MERKEL, PETER A · 2003 to 2008
$6.1M
NCRR NIH HHS U54 RR019497NIAMS NIH HHS U54 AR057319Versus Arthritis 19706
6 · The paper itself

Abstract

objectivesEvaluation of rituximab and glucocorticoids as therapy to induce remission after relapse in ANCA-associated vasculitis (AAV) in a prospective observational cohort of patients enrolled into the induction phase of the RITAZAREM trial.

methodsPatients relapsing with granulomatosis with polyangiitis or microscopic polyangiitis were prospectively enrolled and received remission-induction therapy with rituximab (4×375 mg/m

results188 patients were studied: 95/188 (51%) men, median age 59 years (range 19-89), prior disease duration 5.0 years (range 0.4-34.5). 149/188 (79%) had previously received cyclophosphamide and 67/188 (36%) rituximab. 119/188 (63%) of relapses had at least one major disease activity item, and 54/188 (29%) received the higher dose glucocorticoid regimen. 171/188 (90%) patients achieved remission by 4 months. Only six patients (3.2% of the study population) did not achieve disease control at month 4. Four patients died in the induction phase due to pneumonia (2), cerebrovascular accident (1), and active vasculitis (1). 41 severe adverse events occurred in 27 patients, including 13 severe infections.

conclusionsThis large prospective cohort of patients with relapsing AAV treated with rituximab in conjunction with glucocorticoids demonstrated a high level of efficacy for the reinduction of remission in patients with AAV who have relapsed, with a similar safety profile to previous studies.

Indexed as

AdultAgedAged, 80 and overAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisAntirheumatic AgentsDrug Therapy, CombinationFemaleGlucocorticoidsHumansInduction ChemotherapyMaleMiddle AgedProspective StudiesRecurrenceRituximabTreatment OutcomeAntirheumatic AgentsGlucocorticoidsRituximabB cellsgranulomatosis with polyangiitissystemic vasculitistreatment

Identifiers

PMID32581088
PMCPMC7456549
OpenAlexW3037338668

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.