Article
Rheumatology
Maxime Samson, Herve Devilliers, Sara Thietart, Pierre Charles, Christian Pagnoux, Pascal Cohen, Alexandre Karras, Luc Mouthon, Benjamin Terrier, Xavier Puechal, Loic Guillevin
Summary: The study aimed to develop a score for assessing the likelihood of relapse in granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Long-term follow-up data from patients with GPA and MPA included in five randomized controlled trials were pooled. Variables associated with relapse were identified and used to build a score, which was validated in an independent cohort.
Article
Rheumatology
Burak Ince, Elif Eroglu, Mehmet Barburoglu, Yasemin Yalcinkaya, Bahar Artim-Esen, Ahmet Gul, Murat Inanc
Summary: This case report describes a relapse of granulomatosis with polyangiitis (GPA) with intracranial granulomatous lesions in a patient under maintenance therapy with Rituximab (RTX), suggesting limited efficacy of RTX for granulomatous manifestations in GPA.
INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES
(2023)
Article
Rheumatology
Boris Sorin, Maxime Samson, Cecile-Audrey Durel, Elisabeth Diot, Isabelle Guichard, Aurelie Grados, Nicolas Limal, Alexis Regent, Pascal Cohen, Jeremie Dion, Paul Legendre, Veronique Le Guern, Luc Mouthon, Loic Guillevin, Benjamin Terrier
Summary: The combination therapy of rituximab and methotrexate showed efficacy in treating persistently active GPA with granulomatous manifestations, with an acceptable safety profile. Seven patients experienced severe adverse events, but combination therapy was never withdrawn for safety concerns.
Article
Rheumatology
Rona M. Smith, Rachel B. Jones, Ulrich Specks, Simon Bond, Marianna Nodale, Reem Al-jayyousi, Jacqueline Andrews, Annette Bruchfeld, Brian Camilleri, Simon Carette, Chee Kay Cheung, Vimal Derebail, Tim Doulton, Alastair Ferraro, Lindsy Forbess, Shouichi Fujimoto, Shunsuke Furuta, Ora Gewurz-Singer, Lorraine Harper, Toshiko Ito-Ihara, Nader Khalidi, Rainer Klocke, Curry Koening, Yoshinori Komagata, Carol Langford, Peter Lanyon, Raashid Luqmani, Carol McAlear, Larry W. Moreland, Kim Mynard, Patrick Nachman, Christian Pagnoux, Chen Au Peh, Charles Pusey, Dwarakanathan Ranganathan, Rennie L. Rhee, Robert Spiera, Antoine G. Sreih, Vladamir Tesar, Giles Walters, Caroline Wroe, David Jayne, Peter A. Merkel
Summary: Following remission induction with rituximab, repeat-dose rituximab was superior to azathioprine for preventing disease relapse in patients with AAV with a prior history of relapse.
ANNALS OF THE RHEUMATIC DISEASES
(2023)
Article
Infectious Diseases
Marie Madlener, Marianne Breuninger, Arne Meissner, Henning Stetefeld, Sergej Telentschak, Thorsten Wille, Thilo van Eimeren, Norma Jung
Summary: This article reports a rare case of a brain abscess secondary to otitis media caused by Ureaplasma species in a patient with granulomatosis with polyangiitis (GPA). The diagnosis was made using imaging and laboratory findings, and the patient improved under antibiotic treatment.
Article
Medicine, General & Internal
Keigo Hayashi, Haruki Watanabe, Yuriko Yamamura, Yosuke Asano, Yu Katayama, Sumie Hiramatsu-Asano, Keiji Ohashi, Michiko Morishita, Mariko Narazaki, Yoshinori Matsumoto, Ken-Ei Sada, Jun Wada
Summary: GPA with bronchial involvement is often difficult to treat and requires careful follow-up and evaluation.
Review
Rheumatology
Jan Henrik Schirmer, Beatriz Sanchez-Alamo, Bernhard Hellmich, David Jayne, Sara Monti, Raashid Ahmed Luqmani, Gunnar Tomasson
Summary: This systematic literature review provides evidence on the treatment of antineutrophil cytoplasm antibody-associated vasculitis (AAV) and suggests that cyclophosphamide and rituximab have similar efficacy for remission induction, but rituximab is more effective in relapsing disease. Faster tapering glucocorticoid protocols result in similar remission rates but lower rates of serious infections. Avacopan shows potential for rapid tapering and replacing glucocorticoids. Use of rituximab for maintenance of remission is associated with lower relapse rates compared with azathioprine. Prolonged maintenance treatment reduces relapse rates for both azathioprine and rituximab.
Review
Medicine, General & Internal
Martina Uzzo, Francesca Regola, Barbara Trezzi, Paola Toniati, Franco Franceschini, Renato Alberto Sinico
Summary: EGPA is a rare autoimmune disease characterized by medium and small vessels inflammation, with current treatment regimens involving high doses of glucocorticoids and immunosuppressive drugs. Specific therapeutic approaches for cardiac involvement in EGPA have not been explored yet, and new therapeutic approaches are needed for patients with refractory disease or contraindications to conventional therapies. Efforts are being made towards a more personalized approach and new insights into EGPA pathogenesis, leading to the discovery of new targets for therapy.
FRONTIERS IN MEDICINE
(2021)
Review
Rheumatology
Vincenzo G. Menditto, Giulia Rossetti, Diletta Olivari, Alessia Angeletti, Marco Rocchi, Armando Gabrielli, Giovanni Pomponio
Summary: A systematic review was conducted to analyze the use of RTX and other biologic agents in EGPA patients, revealing that most evaluable patients achieved remission. However, sources of heterogeneity and differences in study design limited the clear interpretation and applicability of the results in clinical practice.
Article
Rheumatology
Boris Sorin, Michele Iudici, Mary-Jane Guerry, Maxime Samson, Philip Bielefeld, Thibault Maillet, Mathilde Nouvier, Alexandre Karras, Lara Meyer, Christian Lavigne, Alexis Regent, Cecile-Audrey Durel, Marc Fabre, Pierre Charles, Quentin Raimbourg, Aurelia Lanteri, Gregory Pugnet, Frederic Riviere, Marc Pineton de Chambrun, Patrice Cacoub, Guillaume Le Guenno, Pierre Jourdain, Arsene Mekinian, Romain Paule, Jeremie Dion, Paul Legendre, Pascal Cohen, Loic Guillevin, Xavier Puechal, Benjamin Terrier
Summary: This study investigated the characteristics of induction failure in patients with granulomatosis with polyangiitis (GPA) and described salvage therapies and their efficacy. The results showed that the characteristics of GPA, salvage therapies, and their efficacy vary according to induction therapy and failure modality.
Article
Rheumatology
Tsu-Yi Hsieh, Ming-Han Chen, Chen-Ching Wu, Wei-Jhe Hong, Cheng-Hsun Lu, Chun-Chi Lu, Ling-Ying Lu, Song-Chou Hsieh, Chang-Youh Tsai, Chien-Sheng Wu, Taiwan Vasculitis Study Grp
Summary: This study investigated the clinical outcomes of granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) patients in Taiwan receiving rituximab induction and reinduction therapy. The results showed that MPA patients had higher rates of kidney involvement and initial creatinine levels compared to GPA patients. Within 24 weeks after the first course of rituximab, there was a significantly higher mortality rate in MPA patients, while the majority of patients receiving rituximab for kidney involvement survived without the need for renal replacement therapy.
INTERNATIONAL JOURNAL OF RHEUMATIC DISEASES
(2023)
Article
Immunology
Pierre M. Bataille, Cecile-Audrey Durel, Dominique Chauveau, Arnaud Panes, Eric Simon Thervet, Benjamin Terrier
Summary: A study conducted in France revealed that despite advances in therapeutic management, the mortality rates of GPA and MPA patients remain high and stable, highlighting the need for further improvement in management.
JOURNAL OF AUTOIMMUNITY
(2022)
Article
Medicine, General & Internal
C. Mettler, C. A. Durel, P. Guilpain, B. Bonnotte, F. Cohen-Aubart, M. Hamidou, J. C. Lega, V Le Guern, F. Lifermann, V Poindron, G. Pugnet, A. Servettaz, X. Puechal, L. Guillevin, B. Terrier
Summary: This retrospective study examines the efficacy and safety of off-label use of biologics for refractory and/or relapsing granulomatosis with polyangiitis (GPA). The study suggests that the use of anti-TNF-alpha and abatacept shows efficacy in less than 50% of patients with refractory and/or relapsing GPA.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2022)
Review
Immunology
Mitsuhiro Akiyama, Yuko Kaneko, Tsutomu Takeuchi
Summary: Rituximab was found effective in inducing and sustaining remission, reducing glucocorticoid dose, and potentially providing greater benefit in ANCA-positive patients with EGPA. Scheduled maintenance treatment with rituximab significantly decreased relapse rates compared to on-demand administration, with no new safety concerns reported.
AUTOIMMUNITY REVIEWS
(2021)
Article
Medicine, General & Internal
Giorgia Carnicelli, Alvise Sernicola, Vito Gomes, Giulia Cundari, Stefania Trasarti, Roberta Priori, Teresa Grieco
Summary: This article reports the clinical features and cutaneous manifestations of an ANCA-positive EGPA patient, emphasizing the importance of dermatologic signs in diagnosis and treatment.
JOURNAL OF CLINICAL MEDICINE
(2022)