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What are Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA)?

  • GPA and MPA are two rare autoimmune diseases that belong to a category of diseases called ANCA-associated vasculitis.1,2
  • They cause vascular damage and necrosis to primarily small vessels, leading to organ failure.

Organ pathology from vascular injury leads to3:

  • Ischemia
  • Hemorrhage
  • Loss of organ function

What are antineutrophil cytoplasmic antibodies (ANCAs)?

Patients with ANCA-associated vasculitides often have antibodies to specific neutrophil cytoplasmic proteins1,3

  • ANCAs directed to proteinase 3 (PR3) are predominantly associated with GPA
  • ANCAs directed to myeloperoxidase (MPO) are more frequently associated with MPA

ANCA titers may fluctuate over the course of the disease.3

References
1.
Gómez-Puerta JA, Hernandez-Rodriguez J, Lopez-Soto A, Bosch X. Antineutrophil cytoplasmic antibody-associated vasculitides and respiratory disease. Chest. 2009;136(4):1101-1111. doi:10.1378/chest.08-3043.
2.
Bosch X, Guilabert A, Espinosa G, Mirapeix E. Treatment of antineutrophil cytoplasmic antibody-associated vasculitis. JAMA. 2007;298(6):655-669.
3.
Langford CA. Vasculitis. J Allergy Clin Immunol. 2010;125(2):S216-S225.

INDICATION

Rituxan (rituximab), in combination with glucocorticoids, is indicated for the treatment of adult patients with Granulomatosis with Polyangiitis (GPA) and Microscopic Polyangiitis (MPA).

Rituxan is not recommended for treatment of patients with severe active infections.

IMPORTANT SAFETY INFORMATION

BOXED WARNINGS

Rituxan administration can result in serious, including fatal, adverse reactions. These include:

  • infusion reactions
  • tumor lysis syndrome (TLS)
  • severe mucocutaneous reactions
  • progressive multifocal leukoencephalopathy (PML)

Warnings and Precautions

Rituxan administration can also result in additional serious, including fatal, adverse reactions including:

  • hepatitis B reactivation
  • other infections including bacterial, fungal, new or reactivated viral infections
  • cardiovascular events

Use of concomitant immunosuppressants other than corticosteroids has not been studied in GPA or MPA patients exhibiting peripheral B-cell depletion following treatment with Rituxan.

Observe patients closely for signs of infection if immunosuppressants other than corticosteroids are used concomitantly.

Common adverse reactions include infections, nausea, diarrhea, headache, muscle spasms, anemia and peripheral edema.

For additional safety information, please see the full prescribing information, including BOXED WARNINGS and Medication Guide.