TY - JOUR T1 - B Cell Strategy to Maintain Remission in ANCA-associated Vasculitides? JF - The Journal of Rheumatology JO - J Rheumatol SP - 4 LP - 5 DO - 10.3899/jrheum.111313 VL - 39 IS - 1 AU - SABINE ADLER AU - PETER M. VILLIGER Y1 - 2012/01/01 UR - http://www.jrheum.org/content/39/1/4.abstract N2 - During the past decades therapeutic regimens in the anti-neutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitides (AAV) aiming at induction or maintenance of remission have undergone substantial changes. Glucocorticoids plus cyclophosphamide as standard therapy for induction have been challenged by monoclonal tumor necrosis factor blocking antibodies; and maintenance therapy with azathioprine has been expanded by methotrexate, leflunomide, and mycophenolate mofetil1,2.Regarding pathogenesis, numerous recent studies have suggested a central role of the ANCA3. In line with this hypothesis, plasma exchange aiming at a reduction of antibody titer showed positive results in life-threatening vasculitis4. Along this line, rituximab (RTX), a chimeric monoclonal anti-CD20 antibody primarily used for therapy of B cell lymphomas, proved to be highly effective in the induction of remission, successfully challenging cyclophosphamide5,6,7. With the US Food and Drug Administration approval of RTX for a single course treatment in both granulomatosis with polyangiitis (GPA; Wegener’s granulomatosis) and microscopic polyangiitis (MPA) in April of 2011, a novel induction regimen was established8.Notably, RTX is the only treatment approved so far. Disease relapses after induction — irrespective of the agent — … Address correspondence to Dr. Villiger. E-mail: Peter.Villiger{at}Insel.ch ER -