Kaitlyn D’Onofrio

DocwireNews

Granulomatosis with&nbsp;polyangiitis (GPA) and&nbsp;microscopic&nbsp;polyangiitis (MPA) in young patients may be successfully managed by rituximab, according to results from a recent trial.&nbsp;The&nbsp;Pediatric Polyangiitis and Rituximab Study, an&nbsp;international, multi-center, open-label clinical trial,&nbsp;included&nbsp;25&nbsp;patients aged between two and 17 years with&nbsp;recurring or newly onset GPA or MPA. Researchers excluded severely ill patients who required&nbsp;mechanical ventilation due to alveolar&nbsp;hemorrhage or required&nbsp;plasmapheresis or dialysis at screening.&nbsp;Most of the patients (n = 19, 76%) had GPA; six (24%) had MPA. Patients were mostly female (n = 20, 80%), white (n = 17, 68%), and had new-onset disease (n = 18, 72%). Median age was 14 years.&nbsp;During the screening period, patients received three doses of methylprednisolone&nbsp;intravenously followed by four weekly 375 mg/m2&nbsp;intravenous doses of rituximab and concomitant oral glucocorticoid taper. After six months&nbsp;of remission induction, patients only received rituximab infusions if necessary. Researchers measured rituximab&rsquo;s effectiveness using the pediatric vasculitis activity score (PVAS). Patients with a 0 PVAS and who took&nbsp;&le; 0.2 mg/kg/day (max 10 mg/day)&nbsp;of oral prednisone or prednisolone equivalent were considered in remission.&nbsp;At baseline, mean PVAS was&nbsp;8. The whole cohort completed the first four doses of rituximab and the six-month remission induction phase, and 24/25 completed at least 18 months of follow-up. During the first six months, every patient experienced at least one adverse event (AE), and 10 serious adverse events (SAEs) occurred in seven patients. The most common AE was infusion-related reactions (IRRs). They were most frequent in the first infusion, occurring in 32% of patients, and became less frequent in subsequent infusions. Infections presented in 68% of patients, the most common being upper respiratory tract infections (16%). Throughout the entire study, 27 SAEs occurred in 12 patients. There were no deaths. After six months, 56% of patients achieved remission, and all patients did so after 18 months.&nbsp;The study&rsquo;s results were presented at the American College of Rheumatology annual meeting.&nbsp;The study authors concluded, &ldquo;In this first global clinical trial of rituximab in pediatric patients with GPA/MPA, rituximab was well tolerated with an overall safety profile comparable to rituximab-treated adults with GPA/MPA. No new safety signals were observed.&rdquo;&nbsp;<a href="https://proddocwire.wpengine.com/neurology/treatment-and-long-term-outcomes-of-primary-central-nervous-system-vasculitis-original-contributions/">Treatment and Long-Term Outcomes of Primary Central Nervous System Vasculitis</a>&nbsp;&nbsp;<a href="https://proddocwire.wpengine.com/docwire-pick/neutrophil-extracellular-traps-in-rheumatic-diseases/">Neutrophil Extracellular Traps in Rheumatic Diseases</a>&nbsp;<a href="https://proddocwire.wpengine.com/abstracts/rituximab-patients-rheumatoid-arthritis/">Safety and Immunogenicity of Rituximab Biosimilar GP2013 After Switch from Reference Rituximab in Patients with Active Rheumatoid Arthritis</a>&nbsp;<a href="https://proddocwire.wpengine.com/docwire-pick/rheumatology-picks/using-ofatumumab-for-sle-when-rituximab-just-wont-do/">Using Ofatumumab for SLE When Rituximab Just Won&rsquo;t Do</a>&nbsp;Source:&nbsp;<a href="https://acrabstracts.org/abstract/pediatric-open-label-clinical-study-of-rituximab-for-the-treatment-of-granulomatosis-with-polyangiitis-gpa-and-microscopic-polyangiitis-mpa/">American College of Rheumatology&nbsp;</a>

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Rituximab Effectively Treats Pediatric Vasculitis Patients

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Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in young patients may be successfully managed by rituximab, according to results from a recent ...

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