Haubitz M.,Medizinische Klinik III Nephrologie
Nephrologe | Year: 2012
Rituximab (RTX), a chimeric monoclonal antibody, has gained importance in the treatment of vasculitis. In 2011 RTX was approved by the US Food and Drug Administration (FDA) for the treatment of granulomatosis with polyangiitis and microscopic polyangiitis as it has been shown to be comparable to cyclophosphamide. In patients with a relapse RTX has shown to give even better results compared to the cytotoxic agent. Nevertheless, as there is insufficient evidence on long-term outcome especially regarding relapse and side effects and taking the treatment costs into account, in Germany RTX cannot be recommended for primary treatment of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis. Regarding cryoglobulinemic vasculitis RTX has replaced cyclophosphamide as it has been shown to be very effective. For all other forms of vasculitis there are not enough data to draw any conclusions but RTX seems to be gaining importance for refractory small vessel vasculitis. © Springer-Verlag 2012.