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2/10
What did I miss?

MAINRITSAN1 showed RTX superior to AZA as maintenance in AAV

RITAZAREM aimed to answer whether RTX is superior to AZA in relapsing AAV

https://pubmed.ncbi.nlm.nih.gov/36958796/

3/10
Methods

GPA/MPA, relapse after remission

Induction (0-4m): RTX+Pred
Maintenance (4-24m): RTX vs AZA
Follow-up (to 36-48m)

Stratified: ANCA type, relapse severity, high/low dose steroids

Primary outcome: from randomization to relapse

4/10
1 tweet results

n=85 each arm

58 yrs, 91% white, 49% male, 28% high-dose steroids

RTX superior to AZA in preventing relapse
HR 0.35 (95% CI 0.18-0.66) in maintenance period
HR 0.45 (0.26-0.78) during further follow-up

SAE: 44% in RTX vs 56% in AZA

6/10 #NephJC
Give me something clever to say:
“After MAINRITSAN-1, these results were pretty expected! This trial attempted to further establish superiority of RTX as maintenance agent over AZA in relapsing AAV after RTX induction”
Here is how the 2 trials differed

7/10
#NephJC Chat consensus?

RTX>AZA for preventing relapse in high-risk relapsing AAV

RTX safer

More data required on duration of effect of RTX

8/10
#NephJC Quote of the fortnight!
https://twitter.com/gratefull080504/status/1656115254344966151?s=20

9/10
I want more info:

Check out the brilliant #NephJC summary from
@myasirbaloch & @nihal_hamary, which is accompanied by an intricately detailed slideset by @husamjz (a new #NephJC feature!!)
http://nephjc.com/news/ritazarem

Visual abstract by @nikitap159
http://www.nephjc.com/news/2023/5/9/the-ritazarem-visual-abstract

Final thoughts

RTX already standard of care for maintenance in AAV - consolidated by RITAZAREM

Up next, the Preserve-Transplant Study - can HCO3 preserve graft function?

Join us on Tuesday/Wednesday for more
https://pubmed.ncbi.nlm.nih.gov/36708734/

#TenTweetNephJC by
@sandyrvsdav brought to @Mastodon by @jmteakell #NephJC