For patients with eosinophilic granulomatosis with polyangiitis (EGPA), rituximab is not superior to the conventional remission induction strategy, according to a study published online July 29 in the Annals of Internal Medicine.

Benjamin Terrier, M.D., Ph.D., from Hôpital Cochin in Paris, and colleagues compared rituximab to a conventional strategy for the induction of remission in patients with EGPA in a phase 3, multicenter superiority trial. Patients with a diagnosis of EGPA, newly diagnosed or relapsing disease at the time of screening, were included and randomly assigned in double-blind fashion to receive glucocorticoids plus rituximab versus the conventional strategy of glucocorticoids alone or in combination with cyclophosphamide in severe forms. The primary end point was remission, defined as a Birmingham Vasculitis Activity Score of 0 and a prednisone dose of 7.5 mg/day or less at day 180.

One hundred five participants were randomly assigned. The researchers found that 63.5% and 60.4% of patients in the rituximab and control groups, respectively, achieved the primary end point (relative risk, 1.05; 95% confidence interval, 0.78 to 1.42; P = 0.75).

Similar results were seen at day 360. The mean duration of remission was 48.5 ± 6.51 and 49.1 ± 7.42 weeks in the rituximab and conventional strategy groups, respectively (P = 0.41). The average daily glucocorticoid dose did not differ significantly between the treatment groups, nor was there a significant difference in the rates of adverse events.

“On the basis of the results of this trial, the role of rituximab in the therapeutic management of EGPA has been updated,” the authors write.

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