{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T17:49:33Z","timestamp":1778262573986,"version":"3.51.4"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Despite the increasing use of rituximab in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), it remains unclear what the optimal dosing is, especially for maintenance of remission. A deeper understanding of post-rituximab B-cell repopulation patterns may aid better-tailored treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a monocentric, retrospective study including ANCA-positive AAV patients receiving a single course of rituximab induction. CD19+ B cells were longitudinally monitored with flow cytometry. B-cell repopulation was defined as CD19+ &amp;gt;10 cells\/\u03bcL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy-one patients were included, the majority with microscopic polyangiitis (75%), myeloperoxidase-ANCA positivity (75%) and with renal involvement (79%). During a median follow-up of 54\u00a0months since the first rituximab infusion, 44 patients (62%) repopulated B cells, with a median time to repopulation of 39\u00a0months (range 7\u2013102). Patients experiencing B-cell depletion lasting longer than the overall median time to repopulation (39\u00a0months) exhibited a lower risk of flare and higher risk of serious infection. In multivariate Cox regression, higher estimated glomerular filtration rate (eGFR) [hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.13\u20132.98 per 30\u00a0mL\/min\/1.73 m2 eGFR] and female sex (HR 2.70, 95% CI 1.37\u20135.31) were independent predictors of increased rate of B-cell repopulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A subset of AAV patients develop sustained post-rituximab B-cell depletion, which associates with reduced risk of flare and increased risk of serious infection in the long term. Preserved renal function and female sex are associated with faster B-cell repopulation. These observations further highlight the need to personalize immunosuppression to improve clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ndt\/gfad197","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T01:09:41Z","timestamp":1694048981000},"page":"683-693","source":"Crossref","is-referenced-by-count":14,"title":["Sustained post-rituximab B-cell depletion is common in ANCA-associated vasculitis and is affected by sex and renal function"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2759-4027","authenticated-orcid":false,"given":"Federica","family":"Mescia","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia , Brescia , Italy"},{"name":"Nephrology Unit, Spedali Civili Hospital , ASST Spedali Civili of Brescia, Brescia , 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