{"doi":"10.17863/cam.124844","title":"Risk factors for relapse in ANCA-associated vasculitis among patients with relapse after induction of remission with rituximab.","abstract":"OBJECTIVE: To determine risk factors for relapse of ANCA-associated vasculitis (AAV) after re-induction of remission with rituximab and discontinuation of maintenance therapy. METHODS: This is a post-hoc analysis of the RITAZAREM clinical trial. Patients 15 years or older with AAV and a positive test for anti-proteinase-3 (PR3-) or anti-myeloperoxidase (MPO)-ANCA who achieved remission after re-induction with rituximab and glucocorticoids were randomized at month 4 to receive continued rituximab or azathioprine for a maintenance period up to 24 months, followed by observation until relapse or up to 48 months. Generalized estimating equations logistic regression identified baseline and time-varying risk factors for relapse by the next visit for the two study phases: maintenance (months 4-24) and off-treatment (months 24-48). RESULTS: Among 170 patients (median (IQR) age 59 (48-68) years, disease duration 5 (2-10) years), 99 relapses occurred (46 during maintenance). During maintenance, musculoskeletal involvement (odds ratio (OR) [95% confidence interval (CI)]: 2.8 [1.1, 7.2], p=0.03) and higher patient global assessment (OR [95% CI]: 1.1 [1.0, 1.2], p=0.04) were associated with relapse. During the off-treatment phase, presence of CD19+ B-cells (OR [95% CI]: 2.5 [1.2, 5.1], p=0.01) and reappearance of ANCA (OR [95% CI]: 3.2 [1.3, 7.7], p=0.01) were each associated with higher relapse risk. Multivariable analysis identified markers of inflammation (changes in platelets, white blood cells, and immunoglobulin A) associated with relapse. CONCLUSIONS: Risk factors for relapse in AAV vary by treatment phase. Monitoring markers of inflammation and immune reconstitution may identify patients at risk for relapse, particularly after treatment withdrawal.","journal":"Open MIND","year":2025,"id":587743,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9557,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1503863,"name":"Joshua F Baker","orcid":null,"position":1,"is_corresponding":false},{"id":1503864,"name":"Thomas R Riley","orcid":null,"position":2,"is_corresponding":false},{"id":1015360,"name":"Ian Green","orcid":null,"position":3,"is_corresponding":false},{"id":1503865,"name":"Rennie Rhee","orcid":null,"position":4,"is_corresponding":false},{"id":1503866,"name":"McAlear, Carol A","orcid":null,"position":5,"is_corresponding":false},{"id":25190,"name":"U. Specks","orcid":null,"position":6,"is_corresponding":false},{"id":1503867,"name":"Rona M. Smith","orcid":null,"position":7,"is_corresponding":false},{"id":1503868,"name":"David R Jayne","orcid":null,"position":8,"is_corresponding":false},{"id":1503869,"name":"Peter A Merkel","orcid":null,"position":9,"is_corresponding":false},{"id":1503870,"name":"RITAZAREM Investigators","orcid":null,"position":10,"is_corresponding":false},{"id":1267033,"name":"Ellen Romich","orcid":"0000-0002-8233-4703","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:59:39.958043Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}