{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T20:49:12Z","timestamp":1792442952876,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007520","name":"Nationwide Children's Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007520","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005247","name":"University of British Columbia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005247","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) are chronic life\u2010threatening vasculitides requiring substantial immunotherapy. Adult trials identified rituximab (RTX) as an alternative to cyclophosphamide (CYC) for remission induction of GPA and MPA. Disease rarity has limited feasibility of similar trials with pediatric patients. We aim to evaluate the relative efficacy and toxicity of CYC and RTX for patients with childhood GPA and MPA through registry\u2010based comparative evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From A Registry of Childhood Vasculitis, we identified patients with GPA and MPA who received induction with RTX or CYC. Pediatric Vasculitis Activity Score (PVAS) and Pediatric Vasculitis Damage Index (pVDI) score evaluated disease activity and damage. Descriptive statistics summarized patient characteristics. RTX and CYC comparisons used logistic regression for primary outcomes of postinduction remission (PVAS = 0) or low disease activity (PVAS \u2264 2). Hospital admission for adverse events and pVDI scores were compared using logistic regression and ordinal regression, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 104 patients, 43% received RTX, 46% CYC, 11% both. Treatment groups did not significantly differ for diagnosis PVAS and onset age. There was no difference in remission among the groups (63% overall; odds ratio [OR] 1.07, 95% confidence interval [CI] 0.45\u20132.52). Hospitalizations occurred in 22% of patients receiving RTX versus 10% patients receiving CYC (OR 2.27, 95% CI 0.73\u20137.05). The median 12\u2010month pVDI score was 1 in both groups (OR 0.98, 95% CI 0.43\u20132.22).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first study comparing CYC and RTX for induction in pediatric GPA and MPA. No significant differences were shown in rates of remission, severe adverse events, or organ damage. Limitations included lack of standardized treatment regimens, retrospectivity, and lack of longitudinal adverse drug\u2010related event data.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25455","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T14:18:58Z","timestamp":1730125138000},"page":"504-512","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparing Rituximab and Cyclophosphamide in Induction Therapy for Childhood\u2010Onset Anti\u2010Neutrophil Cytoplasmic Antibody\u2010Associated Vasculitis: An <scp>ARChiVe<\/scp> Registry Cohort Study"],"prefix":"10.1002","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3432-296X","authenticated-orcid":false,"given":"Samuel J.","family":"Gagne","sequence":"first","affiliation":[{"name":"Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center and University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidya","family":"Sivaraman","sequence":"additional","affiliation":[{"name":"Nationwide Children's Hospital and The Ohio State University  Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Else S.","family":"Bosman","sequence":"additional","affiliation":[{"name":"British Columbia Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Klamer","sequence":"additional","affiliation":[{"name":"The Ohio State University School of Biomedical Science  Columbus Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Morishita","sequence":"additional","affiliation":[{"name":"British Columbia Children's Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Huber","sequence":"additional","affiliation":[{"name":"IWK Health Centre and Dalhousie University  Halifax Nova Scotia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Orjuela","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine and Texas Children's Hospital  Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Eberhard","sequence":"additional","affiliation":[{"name":"Cohen Children's Northwell Health  New Hyde Park New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Myrup","sequence":"additional","affiliation":[{"name":"Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Gerstbacher","sequence":"additional","affiliation":[{"name":"Stanford Children's Hospital  Palo Alto California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1946-3916","authenticated-orcid":false,"given":"Dirk","family":"Foell","sequence":"additional","affiliation":[{"name":"University of Muenster  Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eslam","family":"Al\u2010Abadi","sequence":"additional","affiliation":[{"name":"Birmingham Children's Hospital  Birmingham United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"McErlane","sequence":"additional","affiliation":[{"name":"Great North Children's Hospital and Newcastle University Population Health Sciences Institute  Newcastle upon Tyne United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Cook","sequence":"additional","affiliation":[{"name":"Akron Children's Hospital  Akron Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Wagner\u2010Weiner","sequence":"additional","affiliation":[{"name":"The University of Chicago Medical Center  Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Elder","sequence":"additional","affiliation":[{"name":"University of Florida  Gainesville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Nandini","family":"Moorthy","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Dancey","sequence":"additional","affiliation":[{"name":"Janeway Children's Health and Rehabilitation Centre  St John's Newfoundland and Labrador Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rae","family":"Yeung","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children and University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raju","family":"Khubchandani","sequence":"additional","affiliation":[{"name":"SRCC Children's Hospital, Mumbai  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samundeeswari","family":"Deepak","sequence":"additional","affiliation":[{"name":"Nottingham Children's Hospital  Nottingham United 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