ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2021
PR3-ANCAs predict relapses in ANCA-associated vasculitis patients after rituximab.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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The trial behind it
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- Pooled it
- Do Relapses Follow ANCA Rises? A Systematic Review and Meta-Analysis on the Value of Serial ANCA Level Evaluation.Frontiers in medicine · 2022Pooled it
- Association of baseline soluble immune checkpoints with the risk of relapse in PR3-ANCA vasculitis following induction of remission.Annals of the rheumatic diseases · 2023Trial
- Article
- Structures of proteinase 3 and the CD177 receptor complex reveal a major autoantibody epitope.EMBO reports · 2026Article
- ANCA-associated vasculitis: a phase-oriented therapeutic framework from immunopathology to precision treatment.Frontiers in medicine · 2026Review
- Obinutuzumab treatment for antineutrophil cytoplasmic antibody-associated vasculitis.Frontiers in immunology · 2026Article
- Article
- Review
- Obinutuzumab in Rituximab-Intolerant Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Patients.Kidney international reports · 2025Article
- Biomarkers in ANCA associated vasculitis: clinical utility, pitfalls and their role in the outcomes assessment.Frontiers in immunology · 2025Review
- Antineutrophil cytoplasmic antibody-associated vasculitis: insights into relapse risk and future management directions.Frontiers in immunology · 2025Review
- Two Decades Rituximab Therapy in Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis.Current drug targets · 2025Review
- Clinical utility of proteinase 3-antineutrophil cytoplasmic antibody at diagnosis in predicting subsequent relapse in patients with microscopic polyangiitis.Frontiers in medicine · 2025Article
- An update on risk factors for relapse in antineutrophil cytoplasmic antibody-associated vasculitis.Clinical and experimental immunology · 2024Review
- Computable phenotype for real-world, data-driven retrospective identification of relapse in ANCA-associated vasculitis.RMD open · 2024Article
- New Biomarkers for Systemic Necrotizing Vasculitides.Journal of clinical medicine · 2024Review
- Granulomatosis with polyangiitis: clinical characteristics and updates in diagnosis.Frontiers in medicine · 2024Review
- Anti-topoisomerase 1 Antibody Level Changes after B Cell Depletion Therapy in Systemic Sclerosis.Doklady. Biochemistry and biophysics · 2023Article
- Challenges of defining renal response in ANCA-associated vasculitis: call to action?Clinical kidney journal · 2023Review
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe primary challenge of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patient care is the early detection of relapses to prevent organ damage and increase survival. Potential biomarkers for relapses are ANCA and B cells, but their predictive value is a matter of debate. Therefore this study investigated how ANCA and B-cell status related to relapses in AAV patients treated with rituximab (RTX) as remission induction (RI).
methodsThis single-centre cohort study identified 110 ANCA-positive AAV patients treated with RTX between 2006 and 2018. Serial ANCA, CD19+ B-cell status and relapses were assessed >2 years.
resultsPatients (31/110) relapsed within 2 years after RTX RI treatment. Patients who achieved and maintained PR3-ANCA negativity (n = 29) had few relapses (3%), while persistent proteinase 3 (PR3)-ANCA positivity (n = 49) and reappearance of PR3-ANCAs (n = 10) associated significantly with more relapses (37%, P = 0.002 and 50%, P = 0.002). Patients with incomplete B-cell depletion (n = 11) had significantly more relapses (54%) as compared with patients with B-cell depletion [n = 76 (26%), P = 0.02]. Also, patients with repopulation of B cells (n = 58) had significantly more relapses (41%) as compared with patients without B-cell repopulation [n = 27 (15%), P = 0.03]. Overall, the absence of PR3- or myeloperoxidase (MPO)-ANCA positivity was highly predictive for remaining relapse-free. In PR3-ANCA-positive patients, 96% of the relapses occurred with persistent or reappearance of PR3-ANCAs and 81% with B-cell repopulation. In MPO-ANCA-positive patients, all relapses were restricted to patients with persistent MPO-ANCAs and B-cell repopulation.
conclusionsUpon RI treatment with RTX in AAV patients, ANCA and B-cell status were predictive of the majority of relapses and specifically their absence strongly predicted a relapse-free status. Therefore the implementation of ANCA and B-cell monitoring could guide therapeutic decision-making to prevent relapses in AAV patients treated with RTX.
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Registered trials
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.