PReS-FINAL-2311: Rituximab in paediatric ANCA-associated vasculitis

Introduction

R ituximab is an anti-CD20 monoclonal antibody that has proven to be effective in the treatment of ANCA-associated vasculitis (AAV) in adults. Standard treatments rely on corticosteroids and cyclophosphamide. Only isolated case reports of pediatric AAV treated by rituximab have been reported so far.

Objectives

Our objective was to collect clinical data and outcomes of children with AAV treated with rituximab in a multicenter retrospective study.

Methods

We conducted a retrospective study within the French paediatric rheumatology society (SOFREMIP) in 2011-2012.

Results

We identified 6 children with AAV treated with rituximab (microscopic polyangeitis, n = 2, granulomatosis with polyangeitis, n = 2, unspecified vasculitis, n = 2). The age at onset ranged from 4 to 16 yrs. Treatment with rituximab consisted in 4 infusions of 375 mg/m²; one patient received only 3 infusions. Mean duration of follow-up was 2.65 yrs. All patients achieved clinical remission after 12 months. One patient presented several relapses associated with B cell increase and was dependent on rituximab infusions. No severe adverse event had been reported.

Conclusion

From this multicenter retrospective series, short-term safety and efficicacy of rituximab in pediatric AAV is promising so that B cell depleting agents may represent an alternative to conventional treatment with cyclophosphamide but larger prospective studies are mandatory.

Disclosure of interest

None declared.