The American Journal of Hematology/Oncology—New York, NY—December 21, 2009
According to background information provided in the article, prior to the use of cyclophosphamide treatment, 70% of patients who were diagnosed with severe forms of ANCA-associated vasculitis could be expected to die within 3 years. And although doctors discovered that cyclophosphamide was extremely effective at fighting the disease and could result in remission, they also recognized that came with risk. “If you followed patients long enough, you found they had a higher risk of leukemias, lymphomas, and solid tumors,” said Robert Spiera, MD, an associate attending rheumatologist at Hospital for Special Surgery in New York. “People would sometimes develop terrible infections. Women, almost reliably, would become infertile, as did many men.”
The study led by Ulrich Specks, MD and John Stone, MD, MPH, involved 197 patients with 2 common types of ANCA-associated vasculitis who were given steroids and randomly selected to receive either the standard treatment with cyclophosphamide or Rituxan at a dose of 375 mg/m2 weekly for 4 weeks. Rituxan is a drug approved for the treatment of non-Hodgkin's B cell lymphoma and rheumatoid arthritis. Standard tools were used by the investigators to assess disease status and remission for each participant.
“This study provides strong evidence that Rituxan works as well as cyclophosphamide, at least in terms of getting patients into remission, and over that acute hump of being very ill,” noted Dr Spiera. “And, we can treat patients without the likelihood of causing infertility or causing secondary cancers, which have been a concern with the use of cyclophosphamide.”
The findings were presented at the annual meeting of the American College of Rheumatology.