Session Information
Date: Sunday, November 12, 2023
Title: (0673–0690) Vasculitis – ANCA-Associated Poster I: Treatment Outcomes
Session Type: Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), including Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA), often manifests with life-threatening complications. Cyclophosphamide (CYC) and rituximab (RTX) are the mainstay of remission induction treatment in severe AAV, but their safety and efficacy have not been comprehensively compared in “real-world” settings.
Methods: We conducted a retrospective cohort study using administrative data from the
2006–2019 IBM® MarketScan® Commercial Database. We identified working-age adults (age 18-64 years) with a new diagnosis of GPA/MPA, using the International Classification of Diseases (ICD) version 9 or 10 codes, who received induction treatment with CYC or RTX. We used propensity score matching and a Cox proportional hazard model to estimate hazard ratios (HRs) for the first major disease relapse and severe infection.
Results: We identified 657 patients, 406 (61.8%) of whom were treated with CYC and 251 (38.2%) with RTX. Patients in the CYC group had worse disease severity scores at baseline.
In the 24 months after induction, 146 (22.2%) patients experienced a major disease relapse and 129 patients (19.6%) had severe infection. Multivariate analysis with propensity score matching showed no significant differences between RTX and CYC in the likelihood of experiencing major relapse (HR 0.57, 95% CI 0.32-1.01) or severe infection (HR 0.63, 95% CI 0.30-1.02).
Conclusion: In a nationally representative sample of working-age adults, RTX was found to be comparable to CYC for remission induction treatment in severe AAV.
in the first 24 months following induction
To cite this abstract in AMA style:
Marmor I, Nickel K, Keller M, Hazan G, Baszis K, French A, Hartman M. Real-World Outcomes for Remission Induction in Working-Age Adults with Severe Anti-Neutrophil Cytoplasmic Antibody-associated Vasculitis [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/real-world-outcomes-for-remission-induction-in-working-age-adults-with-severe-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis/. Accessed .« Back to ACR Convergence 2023
ACR Meeting Abstracts - https://acrabstracts.org/abstract/real-world-outcomes-for-remission-induction-in-working-age-adults-with-severe-anti-neutrophil-cytoplasmic-antibody-associated-vasculitis/