Take a look at this nice editorial on The NEJM blog about the two recent trials that just got published in NEJM this week.
The RAVE and the RITUXIVAS trials, both comparing Rituximab to Cyclophosphamide for treatment of ANCA vasculitis.
Both trials were of different protocols and time lengths, but included both p and c ANCA disease.
It comes to many as a surprise that Rituximab is not as promising as we thought once it might be. It is if not at least equal to standard of care cyclophosphamide therapy in this case. Rituxivas found rituximab was not superior to its counter part and had the same adverse degree of events. The RAVE found that rituximab was not inferior but atleast equal to its counterpart.
It comes to many as a surprise that Rituximab is not as promising as we thought once it might be. It is if not at least equal to standard of care cyclophosphamide therapy in this case. Rituxivas found rituximab was not superior to its counter part and had the same adverse degree of events. The RAVE found that rituximab was not inferior but atleast equal to its counterpart.
Take a look at the editorial as well
I think that in both trials the adverse event rate of the rituximab arm was much higher than expected. This might be because both trials, they gave cytoxan as well in that arm, a considerable amount. Probably the rate of adverse events coincides with the degree of net immunosuppresion( cytoxan + rituxan).
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