イハラ　トシコ   Toshiko Ito-Ihara   猪原　登志子    所属   川崎医科大学  医学部 応用医学　先端医療開発学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Real-world effectiveness of rituximab or intravenous cyclophosphamide versus non-use in patients with severe microscopic polyangiitis and granulomatosis with polyangiitis: a retrospective cohort study of J-CANVAS.
掲載誌名	正式名：Modern rheumatology 略　 称：Mod Rheumatol ISSNコード：14397609/14397595
掲載区分	国外
巻・号・頁	36(2),pp.261-271
著者・共著者	Satoshi Omura, Takashi Kida, Junya Kitai, Takuya Yanagida, Daiki Nakagomi, Yoshiyuki Abe, Makoto Wada, Naoho Takizawa, Atsushi Nomura, Yuji Kukida, Naoya Kondo, Hirosuke Takagi, Koji Endo, Shintaro Hirata, Naoto Azuma, Tohru Takeuchi, Shoichi Fukui, Kazuro Kamada, Ryo Yanai, Yusuke Matsuo, Yasuhiro Shimojima, Ryo Nishioka, Ryota Okazaki, Tomoaki Takata, Mayuko Moriyama, Ayuko Takatani, Yoshia Miyawaki, Tsuyoshi Shirai, Hiroaki Dobashi, Takafumi Ito, Isao Matsumoto, Toshihiko Takada, Toshiko Ito-Ihara, Nobuyuki Yajima, Takashi Kawaguchi, Takahiro Seno, Yutaka Kawahito
発行年月	2026/03
概要	OBJECTIVES:To evaluate the real-world effectiveness of rituximab (RTX) and intravenous cyclophosphamide (IVCY) compared to non-use for remission induction in microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA).METHODS:This observational study emulated a target trial using data from the Japan Collaborative Registry of ANCA-associated Vasculitis. Patients aged ≥20 years with newly diagnosed or relapsing MPA or GPA (2017-23) were included. RTX or IVCY use within 4 weeks defined the treatment group; others formed the control group. The primary outcome was failure to achieve remission at week 24 (Birmingham Vasculitis Activity Score = 0 and prednisolone ≤ 10 mg/day). Secondary outcomes included a composite of death, kidney failure, and relapse, and serious infection. In inverse probability weighted population, risk ratios were estimated using modified Poisson regression.RESULTS:Among 544 patients (MPA: 413, GPA: 131), 63.6% received RTX or IVCY. The risk ratio for failure to achieve remission was 0.72 (95% CI: 0.61-0.85), and for the composite outcome was 0.57 (95% CI: 0.33-0.97), and for serious infection was 1.03 (95% CI: 0.47-2.25). Results were robust in sensitivity analyses.CONCLUSIONS:RTX and IVCY improved short-term outcomes in MPA and GPA without increasing infection risk, supporting their recommendation as standard therapy.
DOI	10.1093/mr/roaf090
PMID	41071115