The field of ANCA-associated vasculitis therapy is currently undergoing probably the most momentous change since the effectiveness of adjunctive CYC to treat granulomatosis with polyangitiis (Wegener’s) was discovered in the early 1970s [1, 2]. Since 2001 , the numerous uncontrolled observations reporting the efficacy of the chimeric monoclonal anti-CD20 antibody rituximab against granulomatosis with polyangitiis, microscopic polyangiitis and Churg–Strauss syndrome have sparked enthusiasm and hope that targeted B-cell therapy might cure ANCA-associated vasculitides. In 2010, the New England Journal of Medicine published two randomized clinical trials, Rituximab in ANCA-associated vasculitis (RAVE) and Rituximab versus cyclophosphamide in ANCA-associated vasculitis (RITUXVAS) [4, 5], that provided the first controlled evidence that at 6 or 12 months of follow-up, respectively, rituximab was as effective and safe as conventional immunosuppressive therapy to control active granulomatosis with polyangitiis and microscopic polyangiitis. In a subgroup analysis of RAVE data, rituximab proved to be even more effective at inducing disease remission for those patients enrolled at the time of a relapse .
The rest of the article is here.
What I have to say: Are we ready to change the first line of defense for Vasculitis disease from cychlophosphamide to Rituximab? HECK yes. From talking to other patients Rituximab has less side-effects and puts the patient into remission faster. Plus the patient has less damage to vital organs and can have a normal life with job, family, and kids. Those of us who have used cychlophasphamide are still dealing with damages incurred while trying to get the disease under control. These same patients are still unable to work and usually live very limited lives in isolation.
So I am excited to see this new era of treatment for Vasculitis patients.