Rituxan, a drug that has already been approved for treating non-Hodgkin’s B cell lymphoma and rheumatoid arthritis, can also prove to be an effective option for treating severe ANCA-associated vasculitis. It was noted that the drug can prove its worth just as cyclophosphamide, the current standard therapy.
The finding was presented on October 18, 2009 at the annual meeting of the American College of Rheumatology in Philadelphia.
From Sciencedaily.com:
In the current study, nine centers enrolled a total of 197 patients with severe Wegener’s granulomatosis or microscopic polyangiitis, two of the more common types of ANCA-associated vasculitis. Patients were given steroids and randomized to receive either the standard treatment with cyclophosphamide or Rituxan given at a dose of 375 mg/m2 weekly for four weeks. Investigators used the standard tools to assess disease status and remission. The study was rigorously designed and was double-blinded, meaning that neither patient nor doctor knew which drug individuals were getting.
At the time of the data analysis, 84 of the 99 (85%) patients in the Rituxan arm and 81 of the 98 patients (83%) in the cyclophosphamide arm had completed six months of follow-up. Investigators found that the treatments were equally effective in putting patients into remission and that, in fact, the treatment outcomes looked slightly better in patients receiving Rituxan (64% vs. 55%). This difference, however, was not considered statistically significant (P=0.21).
The Phase III trial was led by Ulrich Specks, M.D., a professor of medicine in the Department of Pulmonary and Critical Care Medicine at the Mayo Clinic, and John Stone, M.D., MPH, director, Clinical Rheumatology, Massachusetts General Hospital and Hospital for Special Surgery was one of nine centers involved in the trial.
It was remarked by Robert Spiera, M.D., an associate attending rheumatologist at Hospital for Special Surgery in New York, that Rituxan is as good as cyclophosphamide in terms of remission and patients can be treated without resulting in infertility or causing secondary cancers, which have been concerns with the use of cyclophosphamide.
